Preventive Health Coverage
ACA-compliant policies must cover comprehensive preventative services.
Typically, preventative services, shots, and screenings do not cost you anything. The provider cannot charge a copayment or coinsurance for these services, even if you have not met your annual deductible.
Keep in mind, these services are only free of charge if administered by a doctor or another network provider.
There are 3 groups of no-fee preventive services:
- Adults
- Women
- Children
Preventive Care Benefits for Adults
Screenings
- Blood pressure
- Diabetes (Type 2) screening for adults 40 to 70 years who are overweight or obese
- Cholesterol
- Abdominal aortic aneurysm
- Colorectal and lung cancer
- Depression
- HIV and Syphilis
- Obesity screening and counseling
- Tobacco
- Tuberculosis, Hepatitis B, and Hepatitis C
Counseling and Advice
- Alcohol misuse screening and counseling
- Aspirin use
- Diet counseling
- Falls prevention
- Sexually transmitted infection (STI) prevention
- Statin preventive
Immunizations
- Influenza (flu shot)
- Tetanus
- Hepatitis A
- Hepatitis B
- Herpes Zoster
- Human Papillomavirus (HPV)
- Measles, Mumps, Rubella
- Meningococcal
- Pneumococcal
- Pertussis
- Diphtheria
- Varicella (Chickenpox)
Preventive Care Benefits for Women
Women’s Pregnancy-related Coverage
Screenings
- Anemia
- Gestational
- Gonorrhea
- Hepatitis B
- Rh incompatibility
- Syphilis
- Urinary tract or other infection
Medications
- Folic acid supplements
- FDA-approved contraceptive medications
Counseling & Services
- Breastfeeding comprehensive support
- Preeclampsia prevention and screening
- Expanded tobacco intervention and counseling for pregnant tobacco users
- Contraception education
- Sterilization procedures
Women’s Preventative Services
Screenings and Testing
- Breast cancer genetic test counseling (BRCA)
- Breast cancer mammography
- Cervical cancer and Pap test
- HumanPapillomavirus (HPV) DNA test
- Chlamydia infection
- Diabetes
- Gonorrhea
- HIV
- Osteoporosis
- Rh incompatibility
- Syphilis
- Tobacco
- Urinary incontinence
- Well-woman visits for women under 65
Counseling
- Breast cancer chemoprevention counseling
- Domestic and interpersonal violence
- HIV counseling
- Sexually transmitted infections
Preventive Care Benefits for Children
Screenings & Assessments
- Alcohol, tobacco, and drug use
- Autism screening
- Behavioral assessments
- Bilirubin concentration
- Blood pressure
- Blood screening
- Cervical dysplasia
- Depression
- Developmental screening
- Dyslipidemia
- Hearing
- Height, weight, and body mass index (BMI) measurements
- Hematocrit or hemoglobin
- Hemoglobinopathies or sickle cell
- Hepatitis B
- HIV screening
- Hypothyroidism
- Lead screening for children at risk of exposure
- Maternal depression screening for mothers of infants
- Obesity
- Oral health risk assessment
- Phenylketonuria (PKU)
- Sexually transmitted infection (STI) prevention counseling and screening
- Tuberculin testing
- Vision screening
Medications & Treatments
- Fluoride chemoprevention supplements
- Fluoride varnish
- Gonorrhea preventive medication for the eyes of all newborns
- Iron supplements
- Medical history for all children throughout development ages
Immunization vaccines
- Diphtheria, Tetanus, Pertussis (Whooping Cough)
- Haemophilus influenza type b
- Hepatitis A
- Hepatitis B
- Human Papillomavirus (HPV)
- Inactivated Poliovirus
- Influenza (flu shot)
- Measles
- Meningococcal
- Pneumococcal
- Rotavirus
- Varicella (Chickenpox)
Where Can I Get the Lowest Price on Health Insurance?
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