ACA-Covered Preventive Care2018-05-16T18:26:04+00:00

Under the Affordable Care Act, most health plans are required to cover a set of preventative services at ZERO cost to you when you use your network’s providers. Take a look at the covered options and make sure that you’re making your yearly wellness visits a priority–with little to no cost to you, you have no excuse to not prioritize your health!

document with affordable care act and medical logo on it, with a brown and gold gavel laying on top

PREVENTIVE CARE COVERED FOR WOMEN

WELLNESS CARE FOR PREGNANT WOMEN

Anemia screening on a routine basis

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

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 plans sponsored by certain exempt “religious employers.” Learn more about contraceptive coverage.

Folic acid supplements for women who may become pregnant

Preeclampsia prevention and screening for pregnant women with high blood pressure

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

Syphilis screening

Expanded tobacco intervention and counseling for pregnant tobacco users

Urinary tract or other infection screening

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

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 pregnant women at their first prenatal visit

PREVENTIVE CARE FOR ALL WOMEN

Well-woman visits to get recommended services for women under 65Cervical cancer screening

Pap test (also called a Pap smear) every 3 years for women 21 to 65

Human Papillomavirus (HPV) DNA test with the combination of a Pap smear every 5 years for women 30 to 65 who don’t want a Pap smear every 3 years

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

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

Domestic and interpersonal violence screening and counseling for all women

Gonorrhea screening for all women at higher risk

HIV screening and counseling for sexually active women

Osteoporosis screening for women over age 60 depending on risk factors

Rh incompatibility screening follow-up testing for women at higher risk

Sexually transmitted infections counseling for sexually active women

Syphilis screening for women at increased risk

Tobacco use screening and interventions

Urinary incontinence screening for women yearly

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

Breast cancer mammography screenings every 1 to 2 years for women over 40

Breast cancer chemoprevention counseling for women at higher risk

young boy sitting on an exam table, with a teddy bear sitting on the ledge behind him, being checked out by a doctor while a parent holds his hand

PREVENTIVE CARE COVERED FOR CHILDREN & ADOLESCENTS

NEWBORN & BABY CARE

Behavioral assessments for children ages: 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years

Bilirubin concentration screening for newborns

Blood pressure screening for children ages: 1 to 4 years , 5 to 10 years, 11 to 14 years, 15 to 17 years

Blood screening for newborns

Developmental screening for children under age 3

Fluoride chemoprevention 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

Height, weight and body mass index (BMI) measurements for children ages 0 to 11 months

Hematocrit or hemoglobin screening for all children

Hemoglobinopathies or sickle cell screening for newborns

Hypothyroidism screening for newborns

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

Iron supplements for children ages 6 to 12 months at risk for anemia

Maternal depression screening for mothers of infants at 1, 2, 4, and 6-month visits

Medical history for all children throughout development ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years

Oral health risk assessment for young children ages: 0 to 11 months, 1 to 4 years, 5 to 10 years

Phenylketonuria (PKU) screening for newborns

Vision screening for all children

SPECIAL SCREENINGS

Alcohol, tobacco, and drug use assessments for adolescents

Autism screening for children at 18 and 24 months

Depression screening for adolescents beginning routinely at age 12

Cervical dysplasia screening for sexually active females

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 ages: 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years

Hepatitis B screening for adolescents at high risk, including adolescents from countries with 2% or more Hepatitis B prevalence, and U.S.-born adolescents not vaccinated as infants and with at least one parent born in a region with 8% or more Hepatitis B prevalence: 11–17 years

HIV screening for adolescents at higher risk

Lead screening for children at risk of exposure

Obesity screening and counseling

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

Tuberculin testing for children at higher risk of tuberculosis ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years

WELLNESS CARE 

Behavioral assessments for children ages 1 to 4 years, 5 to 10 years, 11 to 14 years, AND 15 to 17 years

Blood pressure screening for children ages 1 to 4 years , 5 to 10 years, 11 to 14 years, and 15 to 17 years

Fluoride chemoprevention supplements for children without fluoride in their water source

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

Hearing screening for children once between 11 and 14 years, once between 15 and 17 years, and once between 18 and 21 years

Height, weight and body mass index (BMI) measurements for children 1 to 4 years, 5 to 10 years, 11 to 14 years, and 15 to 17 years

Hematocrit or hemoglobin screening for all children

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

Medical history for all children throughout development ages 1 to 4 years, 5 to 10 years, 11 to 14 years, and 15 to 17 years

Oral health risk assessment for young children ages 1 to 4 years and 5 to 10 years

Vision screening for all children

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PREVENTIVE CARE COVERED FOR ADULTS

WELLNESS CARE FOR ADULTS

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

Blood pressure screening

Cholesterol screening for adults of certain ages or at higher risk

Colorectal cancer screening for adults 50 to 75

Depression screening

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

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:

Statin preventive medication for adults 40 to 75 at high risk

Obesity screening and counseling

SPECIAL SCREENINGS FOR ADULTS 

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

Alcohol misuse screening and counseling

Diet counseling for adults at higher risk for chronic disease

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

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.

Hepatitis C screening for adults at increased risk, and one time for everyone born 1945–1965

Lung cancer screeningThis link takes you to a website not operated by the federal government. The site may have different privacy and security policies. for adults 55-80 at high risk for lung cancer because they’re heavy smokers or have quit in the past 15 years

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

Syphilis screening for adults at higher risk

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

Tuberculosis screening for certain adults without symptoms at high risk