Essential Health Benefits

All health insurance plans available through Connect for Health Colorado are required by federal law to include what are called essential health benefits, including a set of free, preventive services. These are the minimum requirements for all Marketplace plans. Some plans may offer a higher level of service or additional services beyond the minimum required, or exclude other optional services that may be important to you. It’s important to understand these differences when comparing and choosing a plan to meet your needs and budget.

These health benefits and services that include:

  • Doctor visits
  • Hospital stays
  • Emergency room care
  • Maternity and newborn care
  • Prescription drugs
  • Lab tests
  • Preventive tests and services (many are free of charge)
  • Rehabilitative and habilitative services and devices
  • Chronic disease management
  • Mental health care
  • Substance use disorder services
  • Dental care for children
  • Vision care for children

Note regarding chiropractic care: Any provider, including (but not limited to) Doctors of Chiropractic, can provide care for those Essential Health Benefits that are within his/her scope of practice under Colorado law. For those individuals interested in obtaining essential health benefits, as well as other services, from a Doctor of Chiropractic, check to see what providers are in the Health insurance company’s network of providers.

Free Preventive Health Services

As part of the essential health benefits, most health plans must cover a set of preventive services — like cancer screenings, immunizations, smoking cessation, and well-baby and well-child visits — at no cost to you. These services are free, even if you haven’t met your deductible, only when delivered by a doctor or other provider in your plan’s network. Make sure you take advantage of these free services to stay healthy throughout the year!

There are 3 sets of free preventive services. See list of covered services for each group as described on the Healthcare.gov’s website: