PREVENTIVE CARE
100% Coverage for Wellness and Prevention Services
Under the Affordable Care Act
Ladies First
- Anemia Screening on routine basis for pregnant women
- Breast Cancer Genetic Test Counseling (BRCA) for women at higher risk of breast cancer
- Breast Cancer Mammography Screening every 1 to 2 years for women over 40
- Breast Cancer Chemoprevention counseling for women at higher risk
- Breastfeeding comprehensive support and counseling from trained providers, and access to breast feeding supplies, for pregnant and nursing women
- Cervical Cancer screening for sexually active women
- Chlamydia Infection screening for younger women and other women at higher risk
- Contraception: Food and Drug Administration-approved contraceptive methods, sterilization procedures, and patient education and counseling, as prescribed by a health care provider for women with reproductive capacity (not including abortifacient drugs). This does not apply to health sponsored by certain exempt “religious employers”.
- Domestic and interpersonal violence screening and counseling for all women
- Folic Acid supplements for women who may become pregnant
- Gestational diabetes screening for women 24 to 28 weeks pregnant and those at high risk of developing gestational diabetes
- Gonorrhea screening for all women at higher risk
- Hepatitis B Screening for pregant women at their first prenatal visit
- HIV screening and counseling for sexually active women
- Human Papillomavirus (HPV) DNA Test every 3 years for women with normal cytology results who are 30 or older
- Osteoporosis screening for women over age 60 depending on risk factors
- Rh Incompatibility screening for all pregnant women and follow-up testing for women at higher risk
- Sexually Transmitted Infections counseling for sexually active women
- Syphilis screening for all pregnant women or other women at increased risk
- Tobacco Use screening and interventions for all women, and expanded counseling for pregnant tobacco users
- Urinary tract or other infection screening for pregnant women
- Well-woman visits to get recommended services for under 65
Children’s Health
- **Hypothyroidism screening for newborns
- Immunizations vaccines for children from birth to age 18 — doses recommended ages, and recommended populations vary:
- Diphtheria, Tetanus, Pertussis
- Haemophilus influenza type b
- Hepatitis A
- Hepatitis B
- Human Papillomavirus
- Inactivated Poliovirus
- Influenza (flu Shot)
- Measles, Mumps, Rubella
- Meningococcal
- Pneumococcal
- Rotavirus
- Vericella
- Autism screening for children at age 18 and 24 months
- Behavioral assessments for children at the following ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years
- Blood Pressure screening for children at the following ages: 0 to 11 months,1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years
- Cyrvical Dysplacia screening for sexually active females
- Depression screening for adolescents
- Developmental screening for children under age 3
- Dyslipidemia screening for children at higher risk of lipid disorders at the following ages: 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years
- Fluoride Chemoprevention Supplements for children without fluoride in their water source
- Gonorrhea preventive medication for the eyes of all newborns
- Hearing screening for all newborns
- Height, Weight, and Body Mass Index measurements for children at the following ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years
- Hemotocrit or Hemoglobin screening for children
- Hemoglobinopathies or sickle skin screening for newborns
- HIV screening for adolescents at higher risk
- Iron Supplements for children ages 6 to 12 months at risk for anemia
- Lead screening for children at risk of exposure
- Medical History for all children throughout development at the following ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years
- Obesity screening and counseling
- Oral Health risk assessment for young children Ages: 0 to 11 months, 1 to 4 years, 5 to 10 years
- Phenylketonuria (PKU) screening for genetic disorder in newborns
- Sexually Transmitted Infection (STI) prevention counseling and screening for adolescents at higher risk
- Tuberculin testing for children at higher risk of tuberculosis at the following ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years
- Vision screening for all children
Young Adults
If a plan covers children, they can be added or remain on their parent’s plan through the age of 26, even if they fall into the following categories:
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- Married
- Not living with their parents
- Attending school
- Not financially dependent on their parents
- Eligible to enroll in their employer’s plan
What about a Catastrophic plan for young adults?
Coverage for the unexpected and preventable…
“I’m in my 20s and healthy…why do I need insurance?” Healthy young adults often avoid buying health insurance. The new healthcare reform law requires that they be covered. This can be achieved through a “Catastrophic” plan that provides coverage for unexpected high-cost medical needs as well as preventive services for adults under the age of 30, including 3 primary care visits per year.
Adult Men and Women
- Abdominal Aortic Aneurysm one-time screening for men of specified ages who have ever smoked.
- Alcohol Misuse screening and counseling
- Aspirin use to prevent cardiovascular disease for men and women of certain ages
- Blood Pressure Screening for all adults
- Cholesterol Screening for adults of certain ages or at higher risk
- Colorectal Cancer screening for adults over 50
- Depression screening for adults
- Diabetes (Type 2) screening for adults with high blood pressure
- Diet counseling for adults at higher risk for chronic disease
- HIV Screening for everyone ages 15 to 65, and other ages at increased risk
- Immunization vaccines for adults—doses, recommended ages, and recommended populations vary:
- Hepatitis A
- Hepatitis B
- Herpes Zoster
- Human Papillomavirus
- Influenza (Flu Shots)
- Measles, Mumps, Rubella,
- Meningococcal
- Pneumococcal
- Tetanus, Diphtheria, Pertussis
- Vericella
- Obesity screening and counseling for adults
- Sexually Transmitted Infection (STI) prevention counseling for adults at higher risk
- Syphilis screening for all adults at higher risk
- Tobacco Use screening for all adults cessation interventions for tobacco use
What about Teeth?
Under the health care law, dental insurance is treated differently for adults and children 18 and under.
While the new healthcare reform law sees dental coverage for children is an essential health benefit, insurers do not have to provide it for adults. Adults will have to get dental coverage on the exchange as part of a large health plan, or as a stand-alone dental plan. This means it must be available to you either as part of a health plan or as a free-standing plan.
This is not the case for adults. Insurers don’t have to offer adult dental coverage.
