How Preventative Care Fits into Your Health Insurance Policy

If you are enrolled in an ACA-compliant health insurance plan, then you are entitled to receive a broad range of preventative services without cost-sharing responsibilities (money you pay), as long as the service is provided by a provider within your health insurance company’s network. This coverage first began in the fall of 2010 for those who enrolled in a new health insurance plan. Starting in January of 2014, this requirement expanded to plans offered in the individual health insurance market, as well as small and some large group markets.

Covered Preventative Services for Adults and Children

There are four categories of preventative care that health insurance companies are required to provide coverage for without cost-sharing (money you pay).

Screenings and Counseling

Health insurance companies must provide evidence-based screening and counseling services for adults. Covered preventative services for adults includes:

♦ Depression screening

♦ Diabetes screening

♦ Obesity screening

♦ Diet counseling

♦ Screening for certain types of cancer

♦ Screening for HIV and sexually transmitted infection

♦ Blood pressure screening

♦ STI prevention counseling

Routine Immunizations

Health Insurance plans must completely cover routine immunizations for kids and adults, including:

♦ Flu shots

♦ Diphtheria, Tetanus, Pertussis

♦ Hepatitis A

♦ Hepatitis B

♦ Human Papillomavirus

♦ Poliovirus

♦ Measles, Mumps, Rubella

♦ Meningitis (meningococcal and pneumococcal)

♦ Rotavirus

♦ Varicella

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Preventative Services for Children and Teens

In addition to the recommended routine vaccines and health screenings, health insurance plans must also provide coverage for preventative services for kids and teens. This includes:

♦ Behavioral and developmental assessments

♦ Iron and fluoride supplements

♦ Alcohol and drug use assessments

♦ Autism screening for children at 18 months and 24 months

♦ Blood pressure screening

♦ Hearing screening for newborns

♦ Height, weight and body mass index assessments

♦ HIV screening for high-risk adolescents

♦ Tuberculosis testing

♦ Obesity screening and counseling

♦ Oral health risk assessment

Preventative Services for Women

Women with an ACA-compliant health insurance plan are entitled to additional services with no cost-sharing obligations. These include:

♦ Well-woman visits

♦ Cervical cancer screening

♦ FDA-approved contraceptives and related services

♦ Screening and counseling for HIV and STIs

♦ Breastfeeding supplies and counseling

♦ Domestic violence screening

♦ Breast cancer chemoprevention counseling for high-risk women

♦ BRCA counseling about genetic testing for high-risk women

♦ Infection screenings for pregnant women

♦ Anemia screening for pregnant women

♦ Gestational diabetes screening for pregnant women

Understanding Your Health Insurance Coverage with Nevada Insurance Enrollment

Understanding your health insurance coverage is necessary to ensure that you are getting adequate health care service, regardless of your age and health status. To find a comprehensive health insurance policy and understand your health insurance coverage, contact Nevada Insurance Enrollment. Our health insurance agents can discuss your health insurance policy with you to make sure you understand what your policy covers.

Related Articles:

How to get the most out of your Health Insurance plan

What are Essential Health Benefits and who has to have them?

New health insurance plans must cover preventative services

Do you make less than 250% of the Federal Poverty Level?

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