Be Careful to Stay Within Your Network for Preventative Care
New health insurance plans must cover preventative services and there cannot be “cost sharing” – in other words, no co-pays or co-insurance for preventative services.
From the Health and Human Services website, here are some examples of what is covered, without co-pays, co-insurance, or deductibles.
Make sure the doctor’s office bills you correctly for “Preventative” services. If you see the doctor for preventative services only, you should not see a bill. We suggest that if you go to see the doctor for preventative services, do not talk about or have any other services performed. This way, your FREE preventative service will remain free and you should not see a bill.
Those preventative services rated an A or B rating from the U.S. Preventative Services Task Force:
- Children (0-17): Coverage includes regular pediatrician visits, vision and hearing screening, developmental assessments, immunizations, and screening and counseling to address obesity and help children maintain a healthy weight.
- Women (18-64): Coverage includes cancer screening such as pap smears for those ages 21 to 64, mammograms for those ages 50 to 64, and colonoscopy for those ages 50 to 64, recommended immunizations such as HPV vaccination for those ages 19 to 26, flu shots for all adults, and meningococcal and pneumococcal vaccinations for high-risk adults, healthy diet counseling and obesity screening, cholesterol and blood pressure screening, screening for sexually-transmitted infections and HIV, depression screening, and tobacco-use counseling. For plan years (in the individual market, policy years) beginning on or after August 1, 2012, additional preventive services specific to women, such as well-woman visits, screening for gestational diabetes, domestic violence screening and counseling, prescriptions, FDA-approved contraception, must be covered with no cost sharing.
Recent Posts
Why Have PPO Plans Vanished from Nevada’s Individual Market?
The PPO plan decline reflects a Nevada health plan shift, with Nevada Health Link offering HMO/EPO plans due to ACA rules and record 2025 enrollment. These plans limit provider choices but ensure affordable coverage. Learn why PPO plan reduction occurred and how to choose coverage.
Health Insurance Benefits for American Indians
Health insurance for American Indians offers zero cost-sharing, monthly enrollment, and IHS access via Nevada Health Link. The ACA ensures affordable Nevada tribal health coverage with premium tax credits and Medicaid/CHIP options. Learn how to navigate tribal health insurance benefits.
What is a Summary of Benefits and Why Should I Read It?
A summary of benefits (SBC) is a 4-page document explaining a health insurance plan’s coverage, costs, and examples. It helps compare plans, understand costs like premiums and deductibles, and assess coverage for services like doctor visits or preventive care. Available through Nevada Health Link, the SBC is standardized for easy comparison but does not include provider networks or full exclusions. Learn how to use the SBC to choose a plan that fits your needs.