A Qualified Health Plan (QHP) must include essential health benefits as certified by which marketplace?

A Qualified Health Plan (QHP) must include essential health benefits as certified by which marketplace?

• A. Health Insurance Marketplace
• B. Centers for Medicare and Medicaid Services
• C. Qualified Health Plan
• D. State Health Exchange

Answer: (A)

Essential health benefits are the minimum set of services that a Qualified Health Plan must cover, and they are certified by the Health Insurance Marketplace. This marketplace is the platform that reviews and certifies plans offered to individuals and small groups, ensuring each QHP includes the required benefits across the ten categories (ambulatory care, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, prescription drugs, rehabilitative and habilitative services and devices, laboratory services, preventive and wellness services, and pediatric services including oral and vision care). The Marketplace sets these standards and confirms a plan meets them, so it can be marketed as a QHP. While the Centers for Medicare and Medicaid Services administers many federal programs and some marketplaces operate at the state level, the certification of EHB coverage is a function of the Health Insurance Marketplace itself.

Essential health benefits are the minimum set of services that a Qualified Health Plan must cover, and they are certified by the Health Insurance Marketplace. This marketplace is the platform that reviews and certifies plans offered to individuals and small groups, ensuring each QHP includes the required benefits across the ten categories (ambulatory care, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, prescription drugs, rehabilitative and habilitative services and devices, laboratory services, preventive and wellness services, and pediatric services including oral and vision care). The Marketplace sets these standards and confirms a plan meets them, so it can be marketed as a QHP. While the Centers for Medicare and Medicaid Services administers many federal programs and some marketplaces operate at the state level, the certification of EHB coverage is a function of the Health Insurance Marketplace itself.