Essential Health Benefits

Written by Access Health CT | Published May 2nd, 2023 | Updated May 2nd, 2023

Read this article to find out what benefits are covered by every health plan available through Access Health CT. If you're paying for health insurance, you should know what is included with your plan and what services you can get at no cost to you. This information does not apply to our Dental Insurance plans. 

All health insurance plans offered through Access Health CT provide coverage for the same set of Essential Health Benefits. Essential health benefits are minimum requirements for all plans available through Access Health CT. While the cost for certain benefits may vary depending on the selected plan, you can be assured that all plans will provide coverage for:

  • Ambulatory patient services (outpatient care you get without being admitted to a hospital)
  • Emergency room coverage
  • Hospitalization (such as surgery)
  • Maternity and newborn care (care before and after your baby is born)
  • Mental health and substance abuse services, including behavioral health treatment (includes counseling and psychotherapy)
  • Prescription drug coverage
  • 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 service coverage
  • Preventive and wellness services and chronic disease management
  • Pediatric services (including oral and vision care for people under the age of 26)

Plans must also include the following benefits:

  • Birth control coverage
  • Breastfeeding coverage


Some plans offer many additional covered benefits. Specific services covered in each benefit category can vary, so check the Plan Details to see what is covered. Plans may offer additional benefits, including:

  • Dental coverage
  • Vision coverage
  • Medical management programs (for specific needs like weight management, back pain, and diabetes)


Preventive Care

Most health plans must cover a set of preventive serviceslike vaccines and health screenings — at no cost to you. These services are free only when delivered by a doctor or other provider in your plan's network. 

Getting preventive care, like annual checkups which can help you detect or prevent illnesses or diseases from becoming major issues, are the best way to keep your healthcare costs low. Often, you can start using your benefits right away, without worrying about paying a deductible. You can look at your plan documents to identify those benefits, or check with your insurance company to see which benefits your plan covers. 

Looking for a Plan?

You should always review the full plan information before enrolling in a plan to make sure it meets your needs. 

When choosing a plan, think about costs beyond your monthly payment (premium). Pay attention to yearly deductible, co-payments, or co-insurance costs and review the plan's network of providers and prescription drug coverage. For more on comparing health plans, click here. To compare plans and enroll, visit

If you're already enrolled and want to explore all the benefits of your plan, get in touch with your insurance company