Affordable Care Act (ACA) Marketplace benefits to help keep you healthy

Did you know? Getting preventive care reduces the risk for diseases, disabilities, and death — yet millions of people in the United States don’t get recommended preventive health care services.1 People who don’t have health insurance are more likely to be hospitalized for health problems that could be avoided. They’re also more likely to experience declines in their overall health.2 That’s why the benefits included under the Affordable Care Act (also known as Exchange Plans) are designed to help keep you healthier.

Required Affordable Care Act (ACA) Marketplace benefits

All ACA Marketplace plans are required to cover 10 essential health benefits. Keep in mind, these are minimum requirements. That means most ACA Marketplace plans, like UnitedHealthcare Individual & Family ACA Marketplace plans, may offer these benefits -— but some plans may also include many more benefits.

No matter which plan you choose, you're guaranteed to have the following benefits:

  1. Ambulatory patient services (services in places like a clinic, ambulatory surgery center or the outpatient department of a hospital)
  2. Emergency services
  3. Hospitalization
  4. Pregnancy, maternity and newborn care (including contraceptives and breastfeeding coverage)
  5. Mental health and substance use disorder services (including behavioral health treatment)
  6. Prescription medicine
  7. Rehabilitative services and devices
  8. Laboratory services
  9. Pediatric services (including oral and vision care)
  10. Preventive and wellness services, and chronic disease management

All plans include a yearly wellness exam

Your yearly exam is a good opportunity to check in with your provider on how you’re feeling. It’s your chance to bring up any health concerns or questions — and get answers from your provider.

Here are common things that may happen during your yearly exam:

  • Flu shot & other vaccines
  • Cholesterol & blood pressure screenings 
  • Cancer screenings for adults (like breast, colorectal, cervical, lung) 

UnitedHealthcare Individual & Family plans offer more

The essential health benefits explained above are a minimum requirement for all ACA Marketplace plans. UnitedHealthcare Individual & Family plans offer additional more benefits, including:

  • $0 virtual urgent care3
  • $8 or less preferred generic prescription medications3
  • $0 delivery fee for a 90-day supply of most maintenance prescriptions3
  • $0 digital fitness classes through One Pass Select®3
  • $150 rewards for completing a set of activities3
  • 24/7 live chat with a member advocate
  • Digital tools to help you manage your care and coverage
  • Many plans even include coverage for dental and vision care3

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Open enrollment for 2025 Individual & Family ACA Marketplace plans is November 1, 2024 through January 15, 2025. Enroll now.