What is the essential health benefits (EHB) requirement?

The essential health benefits (EHB) requirement mandates that health plans cover a specific set of fundamental health services, ensuring that individuals have access to a comprehensive range of healthcare options. This requirement is pivotal because it guarantees that pivotal services—such as hospitalization, prescription drugs, preventive services, maternity care, and mental health care—are included in the health plans offered in the individual and small group markets.

The significance of this requirement lies in its aim to provide individuals and families with adequate health coverage that addresses a variety of healthcare needs, promoting overall public health and preventing the financial hardships that can come from unexpected medical expenses. By prohibiting annual or lifetime limits on these essential benefits, the EHB requirement also aims to protect consumers from being underinsured, ensuring that even those with serious or chronic health issues can receive the necessary care without exorbitant out-of-pocket costs.

In context, while some other choices suggest important aspects of health insurance, they do not encapsulate the essence of the EHB requirement as comprehensively as this choice does. Selecting plans based solely on major medical expenses, for example, does not cover the full spectrum of essential services, nor does the requirement to include dental coverage specifically for adults fit within the overarching framework of EHBs, which