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Preventive Health Services

  • Writer: Aura Insure
    Aura Insure
  • Jan 6
  • 4 min read

Most health plans must cover a set of preventive services — like shots and screening tests — at no cost to you. Note: These services are free only when delivered by a doctor or other provider in your plan's network.


Preventive services for all adults, women, and children

There are 3 sets of free preventive services.


Preventive care benefits for adults

Abdominal aortic aneurysm one-time screening for men of specified ages who have ever smoked

  1. Alcohol misuse screening and counseling

  2. Aspirin use to prevent cardiovascular disease and colorectal cancer for adults 50 to 59 years with a high cardiovascular risk

  3. Blood pressure screening

  4. Cholesterol screening for adults of certain ages or at higher risk

  5. Colorectal cancer screening for adults 45 to 75

  6. Depression screening

  7. Diabetes (Type 2) screening for adults 40 to 70 years who are overweight or obese

  8. Diet counseling for adults at higher risk for chronic disease

  9. Falls prevention (with exercise or physical therapy and vitamin D use) for adults 65 years and over, living in a community setting

  10. Hepatitis B screening for people at high risk, including people from countries with 2% or more Hepatitis B prevalence, and U.S.-born people not vaccinated as infants and with at least one parent born in a region with 8% or more Hepatitis B prevalence.

  11. Hepatitis C screening for adults age 18 to 79 years

  12. HIV screening for everyone age 15 to 65, and other ages at increased risk

  13. PrEP (pre-exposure prophylaxis) HIV prevention medication for HIV-negative adults at high risk for getting HIV through sex or injection drug use

  14. Immunizations for adults — doses, recommended ages, and recommended populations vary:

    • Chickenpox (Varicella)

    • Diphtheria

    • Flu (influenza)

    • Hepatitis A

    • Hepatitis B

    • Human Papillomavirus (HPV)

    • Measles

    • Meningococcal

    • Mumps

    • Whooping Cough (Pertussis)

    • Pneumococcal

    • Rubella

    • Shingles

    • Tetanus

  15. Lung cancer screening for adults 50 to 80 at high risk for lung cancer because they’re heavy smokers or have quit in the past 15 years

  16. Obesity screening and counseling

  17. Sexually transmitted infection (STI) prevention counseling for adults at higher risk

  18. Statin preventive medication for adults 40 to 75 at high risk

  19. Syphilis screening for adults at higher risk

  20. Tobacco use screening for all adults and cessation interventions for tobacco users

  21. Tuberculosis screening for certain adults without symptoms at high risk


Preventive care benefits for women

Breastfeeding support and counseling from trained providers, and access to breastfeeding supplies, for pregnant and nursing women

  1. Birth control: 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 plans sponsored by certain exempt “religious employers.” Learn more about contraceptive coverage.

  2. Folic acid supplements for women who may become pregnant

  3. Gestational diabetes screening for women 24 weeks pregnant (or later) and those at high risk of developing gestational diabetes

  4. Gonorrhea screening for all women at higher risk

  5. Hepatitis B screening for pregnant women at their first prenatal visit

  6. Maternal depression screening for mothers at well-baby visits

  7. Preeclampsia prevention and screening for pregnant women with high blood pressure

  8. Rh incompatibility screening for all pregnant women and follow-up testing for women at higher risk

  9. Syphilis screening

  10. Expanded tobacco intervention and counseling for pregnant tobacco users

  11. Urinary tract or other infection screening

Get tips to have a healthy pregnancy.

Notice:

You'll be asked if you're pregnant if you select the application option to get help paying for coverage and select "Female" for the question about your sex.


Other covered preventive services for women

  1. Bone density screening for all women over age 65 or women age 64 and younger that have gone through menopause

  2. Breast cancer genetic test counseling (BRCA) for women at higher risk

  3. Breast cancer screening mammogram, with or without clinical breast examination, every 1-2 years for women 40 and older

  4. Breast cancer chemoprevention counseling for women at higher risk

  5. Cervical cancer screening

    • Pap test (also called a Pap smear) for women age 21 to 65

  6. Chlamydia infection screening for younger women and other women at higher risk

  7. Diabetes screening for women with a history of gestational diabetes who aren’t currently pregnant and who haven’t been diagnosed with type 2 diabetes before

  8. Domestic and interpersonal violence screening and counseling for all women

  9. Gonorrhea screening for all women at higher risk

  10. HIV screening and counseling for everyone age 15 to 65, and other ages at increased risk

  11. PrEP (pre-exposure prophylaxis) HIV prevention medication for HIV-negative women at high risk for getting HIV through sex or injection drug use

  12. Sexually transmitted infections counseling for sexually active women

  13. Tobacco use screening and interventions

  14. Urinary incontinence screening for women yearly

  15. Well-woman visits to get recommended services for all women


Preventive care benefits for children

Alcohol, tobacco, and drug use assessments for adolescents

  • Autism screening for children at 18 and 24 months

  • Behavioral assessments for children

  • Bilirubin concentration screening for newborns

  • Blood pressure screening for children

  • Blood screening for newborns

  • Depression screening for adolescents beginning routinely at age 12

  • Developmental screening for children under age 3

  • Dyslipidemia screening for all children once between 9 and 11 years and once between 17 and 21 years, and for children at higher risk of lipid disorders

  • Fluoride supplements for children without fluoride in their water source

  • Fluoride varnish for all infants and children as soon as teeth are present

  • Gonorrhea preventive medication for the eyes of all newborns

  • Hearing screening for all newborns; and regular screenings for children and adolescents as recommended by their provider

  • Height, weight and body mass index (BMI) measurements taken regularly for all children

  • Hematocrit or hemoglobin screening for all children

  • Hemoglobinopathies or sickle cell screening for newborns

  • Hepatitis B screening for adolescents at higher risk

  • HIV screening for adolescents at higher risk

  • Hypothyroidism screening for newborns

  • PrEP (pre-exposure prophylaxis) HIV prevention medication for HIV-negative adolescents at high risk for getting HIV through sex or injection drug use

  • Immunizations for children from birth to age 18 — doses, recommended ages, and recommended populations vary:

    • Chickenpox (Varicella)

    • Diphtheria, tetanus, and pertussis (DTaP)

    • Haemophilus influenza type b

    • Hepatitis A

    • Hepatitis B

    • Human Papillomavirus (HPV)

    • Inactivated Poliovirus

    • Influenza (flu shot)

    • Measles

    • Meningococcal

    • Mumps

    • Pneumococcal

    • Rotavirus

    • Rubella

  • Lead screening for children at risk of exposure

  • Obesity screening and counseling

  • Oral health risk assessment for young children from 6 months to 6 years

  • Phenylketonuria (PKU) screening for newborns

  • Sexually transmitted infection (STI) prevention counseling and screening for adolescents at higher risk

  • Tuberculin testing for children at higher risk of tuberculosis

  • Vision screening for all children

  • Well-baby and well-child visits




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