Regarding Essential Health Benefits (EHBs), what is the requirement status for dental and vision coverage?
Dental and vision coverage is required for children, but the mandate for adults depends on the specific state and plan offering.
The ten categories of Essential Health Benefits (EHBs) provide a broad framework for coverage. Within the Pediatric Services category, the requirements are specific regarding ancillary services like dental and vision care. For children, both pediatric dental care and pediatric vision coverage are mandatory components of the EHB package. However, the requirement for these services in adults is not uniformly mandated across all plans under the Affordable Care Act regulations. The specific inclusion or scope of adult dental and vision coverage often depends on the regulatory structure, mandates, or offerings determined at the individual state level or by the specific plan design chosen by the employer or individual.
