Affordable Care Act (ACA) Requirements

The Affordable Care Act mandates that all essential health benefits (EHBs) be covered to ensure everyone in the individual and small group health insurance markets has access to the same comprehensive coverage that includes the services they need.  The Nova Healthcare plan is compliant with all of these requirements.  

The Nova Healthcare EHB coverages are categorized as follows:

  • Ambulatory patient services (outpatient care you get without being admitted to a hospital)
  • Emergency services
  • Admission to a hospital (like surgery and overnight stays)
  • Pregnancy, maternity, and newborn care (both before and after birth)
  • Behavioral health treatment and substance abuse disorder services (this includes counseling and psychotherapy)
  • Prescription drugs
  • Rehabilitative and habilitative services and devices (services and devices to assist those 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)

Nova Pathfinder Healthcare offers these additional covered services:

  • Dental coverage
  • Vision coverage

Plans must also include the following coverage:

  • Birth control coverage
  • Breastfeeding coverage