Essential Health Benefits

Covered California

All health insurance plans we offer provide a comprehensive package of items and services, known as essential health benefits. These benefits fit into 10 categories:

  1. Ambulatory patient services (outpatient care you get without being admitted to a hospital).

  2. Emergency services.

  3. Hospitalization (like surgery and overnight stays).

  4. Pregnancy, maternity, and newborn care (both before and after birth).

  5. Mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy).

  6. Prescription drugs.

  7. Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills).

  8. Laboratory services.

  9. Preventive and wellness services and chronic disease management.

  10. Pediatric services, including oral and vision care (but adult dental and vision coverage aren’t essential health benefits).

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Critical Illness

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