Nevada Essential Health Benefits

States are allowed flexibility when selecting their EHB-benchmark plan. This page will detail your state’s specific selections.

Nevada EHB Benchmark Requirement List.

The Affordable Care Act requires non-grandfathered health plans in the individual and small group markets to cover essential health benefits (EHB), which include items and services in the following ten benefit categories: (1) ambulatory patient services; (2) emergency services; (3) hospitalization; (4) maternity and newborn care; (5) mental health and substance use disorder services including behavioral health treatment; (6) prescription drugs; (7) rehabilitative and habilitative services and devices; (8) laboratory services; (9) preventive and wellness services and chronic disease management; and (10) pediatric services, including oral and vision care. In addition to the basic EHB benefit categories, Colorado has the following state-required benefits:

In addition to the basic EHB benefit categories, Nevada has the following state-required benefits:

• Coverage for hospice
• Coverage for home care or health support services
• Coverage related to complications of pregnancy
• Plan that includes coverage for maternity care and pediatric care; Requirement to allow minimum stay in hospital in connection with childbirth; prohibited acts
• Coverage for treatment of conditions relating to severe mental illness
• Benefits for treatment of abuse of alcohol or drugs
• Coverage for autism spectrum disorders
• Coverage for human papillomavirus vaccine
• Coverage for prostate cancer screening
• Coverage of certain drugs for treatment of cancer
• Coverage for cytologic screening test and mammograms for certain women
• Coverage for drug or devices for contraception and for hormone replacement therapy in certain circumstances; prohibited actions by insurers
• Coverage for outpatient health care services related to contraceptives and hormone replacement therapy in certain circumstances; prohibited actions by insurers; exceptions
• Coverage for screening for colorectal cancer
• Coverage for treatment of temporomandibular joint
• Coverage for treatment received as part of a clinical trial or study
• Coverage for management and treatment of diabetes
• Coverage for treatment of certain inherited metabolic diseases
• Coverage for prescription drug previously approved for medical condition of insured

Certain limitations and exclusions apply.