A Look at the Affordable Care Act: Preventive Care Coverage

A Look at the Affordable Care Act: Preventive Care Coverage Each month AssuredPartners NL will discuss a different aspect of the Affordable Care Act. Stay tuned for more updates on the second Thursday of each month. Click here for more Affordable Care Act blogs. 

A key health care reform under the Affordable Care Act health is extending preventive care benefits for adults. If you enrolled in a health insurance plan after Sept. 23, 2010, your health plan is now required to cover shots, medical screening tests and other preventive care. This means you do not need to pay any copays, coinsurance or deductibles on services that fall under the recommended preventive care. Types of preventive care benefits covered include:

  • Counseling on topics such as quitting smoking, losing weight, eating better, treating depression and reducing alcohol use*
  • Routine vaccinations for measles, polio, meningitis and other diseases*
  • Flu and pneumonia shots*

Along with the list above, there are several other preventive care services and benefits covered under the Affordable Care Act, including certain services for pregnant women and services to help control and prevent heart disease, obesity and cancer:

Preventive care for a healthy pregnancy

  • Screening for conditions that can harm pregnant women or their babies, such as iron deficiency, hepatitis B, and immune conditions and bacterial infections*
  • Pregnancy-specific counseling from a doctor to help women quit smoking and avoid alcohol use*
  • Counseling to support breast-feeding and help nursing mothers*

Preventive care for heart disease and obesity

  • Screening for obesity, and counseling from health care providers to promote sustained weight loss, including dietary counseling*
  • Blood pressure screening, and tests to screen for high cholesterol and diabetes*
  • Counseling on the daily use of aspirin to reduce the risk of stroke*

Preventive cancer services

  • Annual mammograms for women over age 40, referrals to genetic counseling and discussion of chemoprevention for women at increased risk*
  • Regular Pap smears to screen for cervical cancer and coverage for the HPV vaccine that can prevent cases of cervical cancer*
  • Tobacco cessation interventions including counseling or medication to help individuals quit*
  • Screening tests for colon cancer for adults over age 50*

If your health insurance plan is from Sept. 23, 2013 or earlier, your plan may be considered grandfathered. Grandfathered plans are excluded from certain affordable care act requirements, including the preventive care coverage.

To learn more about the Affordable Care Act and what it means to you, visit the AssuredPartners NL blog on the second Thursday of each month, or visit the AssuredPartners NL Affordable Care Act blog archives. For questions about the Affordable Care Act, contact a AssuredPartners NL representative.

*Source: Zywave

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