All plans offered in the Marketplace cover the same set of essential health benefits.
Essential Health Benefits
Every health plan must cover the following services:
- Ambulatory patient services (outpatient care you get without being admitted to a hospital)
- Emergency services
- Hospitalization (like surgery and overnight stays)
- Pregnancy, maternity, and newborn care (both before and after birth)
- Mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy)
- Prescription drugs
- Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)
- Laboratory services
- Preventive and wellness services and chronic disease management
- Pediatric services, including oral and vision care (but adult dental and vision coverage aren’t essential health benefits)
Additional benefits
Plans must also include the following benefits:
Essential health benefits are minimum requirements for all Marketplace plans. Specific services covered in each broad benefit category can vary based on your state’s requirements. Plans may offer additional benefits, including:
The Michigan Department of Health and Human Services MIBridges login page is a good place to start if you are interested in applying for Michigan Health Plan, Medicaid, MIChild or Emergency Medical Care. You can also apply for food stamps on this site as well.
