Preventive Care and the Affordable Care Act

The Patient Protection and Affordable Care Act (PPACA) includes a provision that requires all medical insurance plans to cover in full a range of preventive care services beginning January 1, 2014. 

Since “preventive care” can have different meanings to different people, the law offers a list of the specific services that are covered under the act. 

When you or a covered family member goes to the doctor for one of these services, you should not be billed for a co-pay, deductible, or coinsurance. You should note, however, that this only applies if your health care provider is in-network. 

The following is a complete list, however, there are a few details about each service that you might want to review on the Healthcare.gov website. 
 

• 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 others at increased risk
• Immunization vaccines for adults--doses, recommended ages, and recommended populations
• 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 and cessation interventions for tobacco users

• Anemia screening on a routine basis for pregnant women
• Breast Cancer Genetic Test Counseling (BRCA) for women at higher risk for breast cancer
• Breast Cancer Mammography screenings every 1 to 2 years for women over 40
• Breast Cancer Chemoprevention counseling for women at higher risk
• Breastfeeding support and counseling from trained providers, and access to breastfeeding 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: FDA-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 plans 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
• Gonorrhea screening for women at higher risk
• Hepatitis B screening for pregnant 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 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 women under 65

• Autism screening at 18 and 24 months
• Behavioral assessments at various ages
• Blood Pressure screening at various ages
• Cervical Dysplasia screening for sexually active females
• Depression screening for adolescents
• Developmental screening for children under 3
• Dyslipidemia screening for children at higher risk of lipid disorders at various ages
• 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 various ages
• Hematocrit or Hemoglobin screening
• Hemoglobinopathies or sickle cell screening for newborns
• HIV screening for adolescents at higher risk
• Hypothyroidism screening for newborns
• Immunization vaccines for children from birth to age 18 —doses, recommended ages, and recommended populations vary – check the healthcare.gov website for a detailed list
• Lead screening for children at risk of exposure
• Medical History for all children throughout development at various ages
• Obesity screening and counseling
• Oral Health risk assessment for young children
• Phenylketonuria (PKU) screening for this 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 various ages
• Vision screening for all children