habilitative coverage

What is habilitative coverage?

Coverage of rehabilitative and habilitative services and devices is mandated as an essential health benefit under the Affordable Care Act for adults and children on individual and small group plans sold both within and outside the health insurance Marketplaces.

Habilitative services are those that help individuals keep, learn, or improve skills and functioning for daily living. Examples include therapy for a child who isn’t walking or talking at the expected age. These services may include physical and occupational therapy, speech-language pathology, and other services for people with disabilities in a variety of inpatient and/or outpatient settings.

Rehabilitative services can be similar, but they’re designed to restore a function that has been lost or damaged, such as physical therapy to regain full mobility after an accident or surgery.