What services do health plans sold on the Marketplace cover?

All health insurance plans offered by the Individual and Small Business Marketplaces include a comprehensive set of benefits, as required by federal regulations, and are considered Minimum Essential Coverage. These comprehensive benefits fit into the following 10 categories:

  • Ambulatory patient services
  • Emergency services
  • Hospitalization
  • Maternity and newborn care
  • Mental health and substance use disorder services, including behavioral health treatment
  • Prescription drugs
  • Rehabilitative and Habilitative services and devices
  • Laboratory services
  • Preventive and wellness services and chronic disease management
  • Pediatric services, including oral and vision care

Health insurance companies have flexibility in determining how these benefits are covered. Health insurance plans may cover additional services, such as chiropractic care. In addition, you may have the option to buy stand-alone dental or vision care through Connect for Health Colorado.