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.

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

Ambulatory patient services (services in places like a clinic, ambulatory surgery center or the outpatient department of a hospital)
Emergency services
Hospitalization
Pregnancy, maternity and newborn care (including contraceptives and breastfeeding coverage)
Mental health and substance use disorder services (including behavioral health treatment)
Prescription medicine
Rehabilitative services and devices
Laboratory services
Pediatric services (including oral and vision care)
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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More resources

Open enrollment for 2025 Individual & Family ACA Marketplace plans starts November 1, 2024. Learn more.

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Footnotes

Source: https://health.gov/healthypeople/objectives-and-data/browse-objectives/preventive-care
Source: https://www.kff.org/uninsured/issue-brief/key-facts-about-the-uninsured-population
The benefits described may not be offered in all plans or in all states. Some plans may require copayments, deductibles and/or coinsurance for these benefits. This policy has exclusions, limitations, reductions of benefits, and terms under which the policy may be continued in force or discontinued. For costs and complete details of the coverage, review your plan documents, call or write your insurance agent or the company, whichever is applicable. Plan specifics and benefits vary by coverage area and by plan category. Please review plan details to learn more. By responding to this offer, you agree that a representative may contact you.

Disclaimers

UnitedHealthcare Individual & Family plans medical plan coverage offered by: UnitedHealthcare of Arizona, Inc.; Rocky Mountain Health Maintenance Organization Incorporated in CO; UnitedHealthcare of Florida, Inc.; UnitedHealthcare of Georgia, Inc; UnitedHealthcare of Illinois, Inc.; UnitedHealthcare Insurance Company in AL, IN, KS, LA, MO, NE, NJ, TN, and WY; Optimum Choice, Inc. in MD and VA; UnitedHealthcare Community Plan, Inc. in MI; UnitedHealthcare of Mississippi, Inc.; UnitedHealthcare of New Mexico, Inc.; UnitedHealthcare of North Carolina, Inc.; UnitedHealthcare of Ohio, Inc.; UnitedHealthcare of Oklahoma, Inc.; UnitedHealthcare of South Carolina, Inc.; UnitedHealthcare of Texas, Inc.; UnitedHealthcare of Oregon, Inc. in WA; UnitedHealthcare of Wisconsin, Inc., and UnitedHealthcare Plan of the River Valley in Iowa. Administrative services provided by United HealthCare Services, Inc. or their affiliates.