What Are Major Insurance Health Benefits?


Quick Answer

Major health benefits include ambulatory patient services, emergency services and hospitalization, pregnancy and maternity care, mental health and substance use disorder services, prescription drugs, and rehabilitative services, reports HealthCare.gov. Additional benefits not always included with major benefits are birth control coverage, breast-feeding coverage, dental coverage and vision coverage.

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Full Answer

Ambulatory patient services relate to treatment when transported and admitted to a hospital, according to HealthCare.gov. Hospitalization can include surgical procedures and overnight stays. Pregnancy, maternity and newborn care are benefits for both before and after birth. Mental health and substance abuse services are for behavioral health treatment options such as counseling and psychotherapy. Rehabilitative services assist people with injuries, disabilities, chronic conditions and aim to recover skills.

Certain health insurance plans have minimum requirements, states HealthCare.gov. However, coverage can also vary depending on certain state requirements. The Affordable Care Act establishes minimum essential coverage for all insurance policies. Individuals with minimum essential coverage do not have to pay a fee for being uninsured. Employers also have requirements under the Affordable Care Act, with the most important being affordability of coverage available. The Employer Shared Responsibility Provision penalizes employers that do not at least offer heath insurance coverage, reports the Henry J. Kaiser Family Foundation.

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