77 Preventive Care Services That Health Insurance Companies Cover

Since the arrival of the Affordable Care Act, the government has required U.S. health insurance companies to cover the cost of preventive health care without charging a copayment, deductible, or coinsurance. These services are provided to you cost-free to keep you as healthy as possible and out of the doctor’s office.

What Are Preventive Care Services?

Preventive health care services are medical office visits or regular appointments that your health insurance covers. Insurance companies foot the bill to prevent certain illnesses and maintain overall health.

Preventative health care services vary, especially amongst age groups, so we have compiled a list of preventative care services that health insurance companies typically cover. 

Preventative Care Services Health Insurance Typically Covers

As stated on Healthcare.gov, “All Marketplace health plans and many other plans must cover the following list of preventive services without charging you.” 

Preventative care services that health insurance companies are required to cover for adults, women, and children include the following:

Services For Adults

Adults with health insurance can expect coverage for the following preventative care services:

  1. Abdominal aortic aneurysm one-time screening 

This screening is free for specific age men who have never smoked.

  1. Alcohol misuse screening and counseling

Alcohol misuse screening and counseling are available free to all adults.

  1. Aspirin use

Aspirin is free to prevent cardiovascular disease and colorectal cancer for high-risk adults between 50 and 59.

  1. Blood pressure screening

Blood pressure screenings are free for all adults.

  1. Cholesterol screening 

Cholesterol screening is free for adults at high-risk or depending on age.

  1. Colorectal cancer screening 

Colorectal cancer screening is free for adults ages 50 to 75.

  1. Depression screening

Depression screenings are free for all adults.

  1. Diabetes (Type 2) screening 

Adults ages 40 to 70 or who are overweight or obese are eligible for Diabetes (Type 2) screening.

  1. Diet counseling

Diet counseling services are free for adults at high-risk for chronic disease.

  1. Fall prevention (with exercise or physical therapy and vitamin D use)

Home adjustments and care for adults ages 65 and up, living in a community setting.

  1. Hepatitis B screening 

Hepatitis B screening for high-risk adults or people from countries with a prevalence of  Hepatitis B at or exceeding 2% and any unvaccinated people with at least one parent having been born in a region with a prevalence of Hepatitis B at exceeding 8%.

  1. Hepatitis C screening 

Hepatitis C screening for high-risk adults and once for all adults born in the years 1945-1965.

  1. HIV screening 

HIV screening is free of charge for all ages 15 to 65 and other increased risk populations.

  1. Immunization vaccines 

A comprehensive panel of immunizations vaccines are available for adults — doses, recommended ages and recommended populations vary:

  1. Lung cancer screening

Lung cancer screening is free for adults ages 55 to 80 and people at high risk for lung cancer due to heavy smoking.

  1. Obesity screening and counseling

Obesity screening and counseling are free for all adults.

  1. Sexually transmitted infection (STI) prevention counseling

STI prevention counseling is free for adults at high-risk.

  1. Statin preventive medication

Statin preventive medication is free for adults ages 40 – 75.

  1. Syphilis screening

Syphilis screening is free for high-risk adults.

  1. Tobacco use screening 

Tobacco use screening is available to and covered for all adults, with additional cessation interventions.

  1. Tuberculosis screening 

Tuberculosis screening is free of charge for non-symptomatic high-risk adults.

Services for Women, Pregnant Women, or Women Who May Become Pregnant

Women, including pregnant women, can expect the following preventive services to be covered by health insurance. 

  1. Anemia screening

Anemia screening is available to pregnant women on a routine basis.

  1. Breastfeeding comprehensive support, counseling from trained providers, and access to breastfeeding supplies

Covered services are available to pregnant and nursing women.

  1. Contraception

Learn more about contraception services that are free by health insurance plans here.

  1. Folic acid supplements

Folic acid supplements are free for women who may become pregnant.

  1. Gestational diabetes screening

Gestational diabetes screening is free for women 24-28 weeks pregnant and women at high risk of developing gestational diabetes.

  1. Gonorrhea screening

Gonorrhea screening is free for all high-risk women.

  1. Hepatitis B screening

Hepatitis B screening is available for all pregnant women at their first prenatal visit.

  1. Maternal depression screening 

Maternal depression screening is available to mothers of infants at 1, 2, 4, and 6-month visits.

  1. Preeclampsia prevention and screening

Preeclampsia prevention services and screening is free for pregnant women with high blood pressure.

  1. Rh incompatibility screening

Rh incompatibility screening is free for all pregnant women, as well as follow-up visits for high-risk women.

  1. Syphilis screening

Syphilis screening is available for all women.

  1. Expanded tobacco intervention and counseling

This counseling is free for pregnant tobacco users.

  1. Urinary tract and other infection screening

Urinary tract and other infection screenings are free for all pregnant women.

  1. Breast cancer genetic test counseling (BRCA) 

Breast cancer genetic test counseling (BRCA) is available to all high-risk women.

  1. Breast cancer mammography screenings every 1 to 2 years

Mammography screenings every one to two years are free for women over the age of 40.

  1. Breast cancer chemoprevention counseling for women at higher risk

Breast cancer chemoprevention counseling is for women at high risk of breast cancer.

  1. Cervical cancer screening

Cervical cancer screening is for all women.

  1. Chlamydia infection screening 

Younger women and women at high risk can get a chlamydia infection screening free of charge.

  1. Diabetes screening 

Diabetes screening is free for non-pregnant women with a history of gestational diabetes but have never been diagnosed with Type 2 Diabetes.

  1. Domestic and interpersonal violence screening and counseling

Screening and counseling for domestic and interpersonal violence are free for all women.

  1. HIV screening and counseling

HIV screening and counseling are available to all women.

  1. Osteoporosis screening

Osteoporosis screening is reserved for women over the age of 60 or depending on risk factors.

  1. Sexually transmitted infections counseling

STI counseling is available to all sexually active women

  1. Tobacco use screening and interventions

Tobacco use screenings and interventions are free for all women.

  1. Urinary incontinence screening 

Urinary incontinence screenings are free for all women once yearly.

  1. Well-woman visits to get recommended services

Well-woman visits to learn about recommended services are available for women under 65.

Services For Children

Children, from infants to adolescents, on a health insurance plan can expect coverage for the following:

  1. Alcohol, tobacco, and drug use assessments

Alcohol, tobacco, and drug use assessments are free for all adolescents.

  1. Autism screening

Autism screening is free for children at 18 and 24 months old.

  1. Behavioral assessments 

Available to all children at ages 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, and 15 to 17 years.

  1. Bilirubin concentration screening 

Bilirubin concentration screenings are available to all newborns free-of-charge.

  1. Blood pressure screening 

Blood pressure screening is free for all children ages 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, and 15 to 17 years.

  1. Blood screening

Blood screening is free by health insurance for all newborns.

  1. Cervical dysplasia screening

Cervical dysplasia screening is free for all sexually active females.

  1. Depression screening 

Depression screenings are free for all adolescents starting at age 12

  1. Developmental screening

Developmental screening is free for children under age 3

  1. Dyslipidemia screening 

Dyslipidemia screening is available for children varying by age group and risk levels.

  1. Fluoride chemoprevention supplements

Fluoride chemoprevention supplements are available free for children living in locations without fluoride in the water source.

  1. Fluoride varnish

All children can receive a fluoride varnish covered by health insurance.

  1. Gonorrhea preventive medication

Gonorrhea preventive medication is free for all newborns.

  1. Hearing screening 

Hearing screenings are free by health insurance for all ages, with the schedule varying per age group.

  1. Height, weight, and body mass index (BMI) measurements

Available to all children at ages 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, and 15 to 17 years.

  1. Hematocrit or hemoglobin screening

Hematocrit or hemoglobin screenings are available to all children.

  1. Hemoglobinopathies or sickle cell screening

Hemoglobinopathies or sickle cell screenings are available to all children.

  1. Hepatitis B screening 

Hepatitis B screening is free for high-risk children ages 11 to 17 years, including those from countries with a Hepatitis B prevalence of 2% or more or with at least one parent born in a region with a prevalence of 8% or greater of Hepatitis B.

  1. HIV screening

HIV screenings are free for adolescents at high-risk.

  1. Hypothyroidism screening

Hypothyroidism screenings are free for newborns

  1. Immunization vaccines 

Immunization vaccines are free for children from birth to age 18.  Doses, recommended ages, and recommended populations vary.

  1. Iron supplements 

Iron supplements are free for children at high-risk for anemia.

  1. Lead screening

Lead screening is for children at risk of exposure.

  1. Medical history 

All children can receive a medical history free of charge during their developmental years.

  1. Obesity screening and counseling

Obesity screening and counseling are available for all children.

  1. Oral health risk assessment

Oral health risk assessments are available to all children ages 0 to 11 months, 1 to 4 years, and 5 to 10 years.

  1. Phenylketonuria (PKU) screening

PKU screenings are available to all children ages zero to 11 months, one to four years, and five to 10 years.

  1. Sexually transmitted infection (STI) prevention counseling and screening

STI prevention counseling and screening are available for free to adolescents at high-risk.

  1. Tuberculin testing 

Tuberculin testing is free for high-risk children ages: zero to 11 months, one to four years, five to 10 years, 11 to 14 years, 15 to 17 years.

  1. Vision screening

Vision screenings are free for all children.

What Services Aren’t Covered by Health Insurance Plans?

Some services that seem like preventative care do not fall under the umbrella of services that health insurance companies will cover.

These services may include non-routine tests and screenings, additional primary care visits, specialist visits, homeopathic doctor visits, and PSA blood tests. Health insurance plans often don’t cover these types of visits.

However, insurance companies make exceptions for high-risk or special populations. Be sure to check your health insurance plan and contact the insurance company if you have any questions about your coverage.

How Can You Make Sure Your Preventive Care Appointments are Covered?

You have some options to verify that your health insurance will cover your preventative care service bill. You can either cross-reference our list with your policy’s Explanation of Benefits (EOB) or go straight to the source. Ideally, you should contact your medical office, health insurance member-services representative, or both to be doubly sure.

Speaking with your general physician is recommended as well. They could help determine if any preventative care is necessary. Your physician might explain your mild symptoms due to a dietary change or new stress in your life and might have simple home remedies in mind rather than a costly appointment.

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