What are "essential health benefits" in Massachusetts?

"Essential health benefits" refer to a defined set of health care service categories that must be covered by specific health insurance plans, particularly those sold through the health insurance marketplace and certain qualified health plans. This includes services like emergency services, hospitalization, maternity and newborn care, mental health services, and pediatric services, among others.

The goal of essential health benefits is to ensure that individuals have access to comprehensive health care coverage that meets their fundamental health needs, enhancing health care quality and reducing financial barriers for consumers. By mandating that health insurance plans cover these essential benefits, Massachusetts seeks to provide a standardized level of care that is available to a wide range of individuals.

Other options do not accurately capture the intent and legal requirements of essential health benefits. While some interpretations may imply a broader set of services or optional benefits, the defining aspect of essential health benefits is their mandatory nature for certain plans.