Preventative Health Services

Preventative Health Services

The following preventive services must be covered without your having to pay a copayment or coinsurance or meet your deductible. This applies only when these services are delivered by a participating provider. Visit www.healthcare.gov for additional information on preventive health services. IF YOUR PLAN IS GRANDFATHERED, THESE BENEFITS MAY NOT BE AVAILABLE TO YOU.

Covered Preventive Services for Adults

• Abdominal Aortic Aneurysm one-time screening for men age 65 or older who have ever smoked
• Alcohol Misuse screening and counseling
• Aspirin use 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 age 50 and older
• Depression screening for adults
• Type 2 Diabetes screening for adults with high blood pressure
• Diet counseling for adults at higher risk for chronic disease
• HIV screening for all adults at higher risk • Immunization vaccines for adults–doses, recommended ages, and recommended populations vary:
Hepatitis A Measles, Mumps, Rubella
Hepatitis B Meningococcal
Herpes Zoster Pneumococcal
Human Papillomavirus Tetanus, Diphtheria, Pertussis
Influenza (Flu Shot) Varicella
• Obesity screening and counseling for all adults
• Sexually Transmitted Infection (STI) prevention counseling for adults at higher risk
• Tobacco Use screening for all adults and cessation interventions for tobacco users
• Syphilis screening for all adults at higher risk

Covered Preventive Services for Women, including PREGNANT WOMEN

Note: Services marked with an asterisk (*) must be covered with no cost-sharing in plan years starting on or after August 1, 2012.

• Anemia screening on a routine basis for pregnant women
• Bacteriuria urinary tract or other infection screening for pregnant women
• BRCA counseling about genetic testing for women at higher risk of breast or ovarian cancer
• Breast Cancer Mammography screenings every 1 to 2 years for women age 40 and older
• Breast Cancer Chemoprevention counseling for women at higher risk
• Breastfeeding comprehensive support and counseling from trained providers, as well as 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: Food and Drug Administration-approved contraceptive methods, sterilization procedures, and patient education and counseling, not including abortifacient drugs*
• 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 of developing gestational diabetes*
• Gonorrhea screening for all women at higher risk
• Hepatitis B screening for pregnant women at their first prenatal visit
• Human Immunodeficiency Virus (HIV) screening and counseling for sexually active women*
• Human Papillomavirus (HPV) DNA Test: high risk HPV DNA testing every three years for women with normal cytology results who are 30 or older*
• Osteoporosis screening for women age 60 and over depending on risk factors
• RH Incompatibility screening for all pregnant women and follow-up testing for women at higher risk
• Tobacco Use screening and interventions for all women, and expanded counseling for pregnant tobacco users
• Sexually Transmitted Infections (STI) counseling for sexually active women*
• Syphilis screening for all pregnant women or other women at increased risk
• Well-woman visits to obtain recommended preventive services for women under 65*

Covered Preventive Services for Children

• Alcohol and Drug Use assessments
• Autism screening for children at 18 and 24 months
• Behavioral assessments for children of all ages
Ages: 0 to 11 months, 1 to 4 years, 5 to 10 years,
11 to 14 years, 15 to 17 years.
• Blood Pressure screening for children
Ages: 0 to 11 months, 1 to 4 years, 5 to 10 years,
11 to 14 years, 15 to 17 years.
• Cervical Dysplasia screening for sexually active females
• Congenital Hypothyroidism screening for newborns
• Depression screening for adolescents
• Developmental screening for children under age 3, and surveillance throughout childhood
• Dyslipidemia screening 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.
• 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
Ages: 0 to 11 months, 1 to 4 years, 5 to 10 years,
11 to 14 years, 15 to 17 years
• Hematocrit or Hemoglobin screening for children
• Hemoglobinopathies or sickle cell screening for newborns • HIV screening for adolescents at higher risk
• Immunization vaccines for children from birth to age 18 — doses, recommended ages, and recommended populations vary:
Diphtheria, Tetanus, Pertussis Influenza (Flu shot)
Haemophilus influenzae type b Measles, Mumps, Rubella
Hepatitis A Meningococcal
Hepatitis B Pneumococcal
Human Papillomavirus Rotavirus
Inactivated Poliovirus Varicella
• Iron supplements for children ages 6 to 12 months at risk for anemia
• Lead screening for children at risk of exposure
• 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
• Obesity screening and counseling
• Oral Health risk assessment for young children
Ages: 0 to 11 months, 1 to 4 years, 5 to 10 years
• Phenylketonura (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
Ages: 0 to 11 months, 1 to 4 years, 5 to 10 years,
11 to 14 years, 15 to 17 years
• Vision screening for all children
 

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