What is an essential health benefits package?

An essential health benefits package is a set of benefits and services that health insurance plans must cover in order to comply with the Affordable Care Act (ACA). These benefits are designed to make health care more accessible to individuals and families, regardless of their income or health status. In the state of Florida, an essential health benefits package must include: 1. Ambulatory patient services – This includes any out-patient care provided by a doctor or other medical practitioner, for diagnosis or treatment. 2. Emergency services – This includes emergency room visits, ambulance transportation, and related services. 3. Hospitalization – This includes hospital room services, surgical services, and lab tests. 4. Maternity and newborn care – This includes routine care for pregnant women and newborns following birth. 5. Mental health and substance use disorder services – This includes counseling and treatments related to mental health issues or substance use disorders. 6. Prescription drugs – This includes medications prescribed to treat an illness or condition, and related services. 7. Rehabilitative and habilitative services and devices – This includes treatments and services to help people recovering from injury, disability, or chronic conditions. 8. Laboratory services – This includes diagnostic and preventive laboratory services related to the diagnosis and treatment of medical conditions. 9. Preventive and wellness services and chronic disease management – This includes preventive care, such as vaccines, screenings, and treatment for chronic illnesses. 10. Pediatric services – This includes preventive care, vision and hearing services, as well as dental care for children under 19 years of age. By including all of these benefits, health insurance plans in Florida must provide comprehensive coverage to its members. This helps make sure that everyone has access to high-quality health care services.

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