Which services are considered essential health benefits covered by QHPs?

Prepare for the PY 2025 Pennie Individual Marketplace Training with engaging multiple choice questions and detailed explanations. Equip yourself with the knowledge needed to excel on your first attempt!

Qualified Health Plans (QHPs) are required to cover a set of essential health benefits as defined by the Affordable Care Act. These essential health benefits include a comprehensive range of services designed to address various health care needs, ensuring that individuals have access to necessary medical care without facing insurmountable costs.

The correct response highlights key services that fall under these essential health benefits, including maternity care, which provides necessary prenatal, delivery, and postnatal support for expectant mothers. Hospitalization covers the costs associated with inpatient care within a hospital setting, addressing significant medical needs that may arise. Emergency services are critical for providing immediate care in life-threatening situations, ensuring that individuals can access urgent medical attention as needed.

In contrast, the other options focus on limited or non-essential services. Preventative services and dental care, while important, do not encompass the full range of essential health benefits as mandated for QHPs. Likewise, high-cost specialty drugs and life coaching extend beyond the foundational health needs covered under the essential health benefits category. Lastly, outpatient care and diagnostic services are also important elements of health care, but they do not represent the comprehensive array of services classified as essential health benefits in the context of QHPs.

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