Shop and Save with Essential Plans

Essential Plans make health care more affordable and accessible. Essential Plans, also called standard plans, cover primary care, specialists, urgent care, and generic drugs without deductibles. They provide free type 2 diabetes, heart disease and stroke care from family doctors and $5 care for pediatric mental health care. They also provide free insulin. To get these lower costs, you must enroll in an Essential Plan.

Covering service before you meet your deductible
ESSENTIAL PLANS COVER ESSENTIAL CARE WITHOUT DEDUCTIBLES FOR IN-NETWORK PROVIDERS.

This includes:

  • Primary care visits
  • Specialist visits
  • Urgent care visits
  • Mental and behavioral health care visits
  • Generic prescription drugs
Covering service before you meet your deductible
ESSENTIAL PLANS ALSO PROVIDE FREE TYPE 2 DIABETES, HEART DISEASE AND STROKE CARE, AND $5 CARE FOR PEDIATRIC MENTAL HEALTH.

Free type 2 diabetes care with no deductibles, no coinsurance, and no copayments, including:

  • Prescription drugs, including insulin
  • Lab tests, including: a lipid panel, Hemoglobin A1C, a Microalbumin urine test or nephrology visit, a basic metabolic panel, a liver function test
  • A dilated retinal exam per year
  • A diabetic foot exam per year
  • Primary care visits
  • Diabetic supplies
  • Nutritional counseling visits

Free heart disease and stroke care with no deductibles, no coinsurance, and no copayments, including:

  • Prescription drugs, including: ACE inhibitors, statins, beta blockers, NSAIDS, anticoagulants, and platelet inhibitors such as Plavix
  • CT Scan
  • Electrocardiogram (EKG/ECG)
  • Lab tests, including: lipid panel, blood chemistry, blood pressure reading, blood cell count, urinalysis, troponin testing, and nicotine test
  • Primary care visits
  • Nutritional counseling visits
  • Smoking cessation counseling visits

$5 pediatric mental health care with no deductibles for children ages 18 and under, including:

  • Pediatrician visits
  • Psychiatrists, psychologists, and other specialist visits
  • Individual, family and group therapy
  • Certain prescription drugs, including: antidepressants, anti-hypertensives, anxiolytics, anti-psychotics, and hormone treatment
  • Gender dysphoria services, including labs
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Comparing Essential Plans makes it faster and easier to find a plan that meets your needs and budget. All Essential Plans at the same metal level have the same cost for doctors’ visits and generic drugs. The major differences among Essential Plans at the same metal level are monthly premiums and provider networks. Use our Plan Match tool to compare plans and see which plans include your prescription drugs and preferred doctors.