Preventative Services
All Marketplace health plans and many other plans must cover the following list of preventive services without charging you a copayment or coinsurance. This is true even if you haven’t met your yearly deductible.
These services are free ONLY when delivered by a doctor or other provider in your plan’s network.
Preventative Services for Adults
Abdominal aortic aneurysm one-time screening for men of specified ages who have ever smoked
Alcohol misuse screening and counseling
Aspirin use to prevent cardiovascular disease for men and women of certain ages
Blood pressure screening
Cholesterol screening for adults of certain ages or at higher risk
Colorectal cancer screening for adults over 50
Depression screening
Diabetes (Type 2) screening for adults with high blood pressure
Diet counseling for adults at higher risk for chronic disease
Hepatitis C screening for adults at increased risk, and one time for everyone born 1945 – 1965
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:
Lung cancer screening for adults 55 – 80 at high risk for lung cancer because they’re heavy smokers or have quit in the past 15 years
Obesity screening and counseling
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
Preventative Services for Pregnant Women or Women Who May Become Pregnant
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
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
Rh Incompatibility screening for all pregnant women and follow-up testing for women at higher risk
Expanded tobacco intervention and counseling for pregnant tobacco users
Other Preventative Services for Women
Yes! Here is a list of other preventative services for women:
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
Cervical cancer screening for sexually active women
Chlamydia infection screening for younger women and other women at higher risk
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
Human Papillomavirus (HPV) DNA test every 3 years for women with normal cytology results who are 30 or older
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
Well-woman visits to get recommended services for women under 65
Preventative Services for Children
All Marketplace health plans and many other plans must cover the following list of preventive services for children without charging you a copayment or coinsurance. This is true even if you haven’t met your yearly deductible.
Alcohol and drug use assessments for adolescents
Autism screening for children at 18 and 24 months
Behavioral assessments for children 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
Depression screening for adolescents
Developmental screening for children under age 3
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 (BMI) 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 all children
Hemoglobinopathies or sickle cell screening for newborns
HIV screening for adolescents at higher risk
Hypothyroidism screening for newborns
Immunization vaccines for children from birth to age 18 — doses, recommended ages, and recommended populations vary:
Diphtheria, Tetanus, Pertussis (Whooping Cough)
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
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 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