APTA's Essential Health Benefits (EHB) webpage provides an overview of this new benefit package, established under the Affordable Care Act, which ensures that certain health plans offered in the state Health Insurance Exchanges (exchanges) provide a baseline of coverage, benefits, and services to their enrollees.
Most health plans that will be offered in exchanges, with some exceptions, must cover 10 categories of benefits in order to be certified and offered in the exchanges. Of particular interest to physical therapists is the rehabilitative and habilitative services and devices category. Although rehabilitative services will be mandatory services in most Qualified Health Plans, states will most likely impose annual visit limits, caps, or other restrictions for therapy services as current employer-sponsored plans do. Therefore, it is imperative that physical therapists continue to educate state legislators, state policy makers, and consumers of the value, benefits, and cost savings of physical therapy services.
Find background information on essential health benefits, a map of Medicaid and exchanges coverage by state, resource for state and chapter advocacy efforts, and more on this 1-stop resource page.
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