Which type of policies are required to have essential benefits without annual and lifetime limits?

Policies purchased through the Federal Marketplace are mandated to include essential health benefits as part of the Affordable Care Act (ACA). This requirement ensures that these policies cover a comprehensive range of healthcare services, including preventive services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, prescription drugs, rehabilitation and habilitation services, and pediatric services.

Moreover, annual and lifetime limits on essential health benefits are prohibited under these policies, which means that enrollees have continuous access to necessary health care without the risk of exhausting their coverage. This aspect of the Federal Marketplace policies plays a crucial role in protecting consumers and ensuring they have access to necessary health services throughout the year and over their lifetime.

While private health policies may decide to offer similar benefits, they are not universally required to do so under federal law unless they are considered to be part of the ACA-compliant marketplaces. Employer-sponsored health policies can vary widely in coverage, and Medicaid policies are governed by different state and federal regulations which also dictate their essential benefits, though they generally do include comprehensive coverage.