What Does Health Insurance Cover?

Coverage depends on the specific policy.

For example, U.S. Marketplace plans cover categories including:

• Outpatient care
• Emergency services
• Hospitalization
• Pregnancy, maternity, and newborn care
• Mental health and substance use disorder services
• Prescription drugs
• Rehabilitation services
• Laboratory services
• Preventive and wellness services
• Pediatric services

However, even when a service is a covered benefit, you may still have to pay a deductible, copayment, or coinsurance depending on the plan.

For this reason, don’t assume that a service being “covered” means you will pay nothing.