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What services/benefits must plans cover? What are essential health benefits?


After January 1, 2014, plans sold in the individual and small employer market, including those sold through the Health Insurance Marketplace and SHOP Marketplace for Small Businesses, as well as most plans sold in the market outside the exchange, must cover, at a minimum, a comprehensive set of benefits known as essential health benefits. These essential health benefits include the following:

Many documents about the Nebraska essential health benefits can be found at the NAIC website under Essential Health Benefits Data from The Center for Consumer Information and Insurance Oversight (CCIIO).

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