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Frequently Asked Questions Insurance

What benefits are required in Multi-State Plan coverage?

A Multi-State Plan insurer must offer a benefits package that is uniform within each State and includes “essential health benefits” in the following categories:

1.Ambulatory patient services
2.Emergency services
3.Hospitalization
4.Maternity and newborn care
5.Mental health and substance use disorder services, including behavioral health treatment
6.Prescription drugs
7.Rehabilitative and habilitative services and devices
8.Laboratory services
9.Preventive and wellness services and chronic disease management
10.Pediatric services, including oral and vision care

A Multi-State Plan insurer must also offer any additional benefits required under its State’s laws.

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