On March 23, 2010 the Affordable Care Act was signed into law and a new breed of insurance and health care policy was born. Among the many facets of the Patient Protection and Affordable Care Act (PPACA), is that of preventive care and services. Now the Average Joe (courtesy of Sarah Palin) may be able to benefit from PPACA if they have a non-grandfathered plan. Keyword: NON. Any policies written after March 23, 2010 have the magical status of “Non-Grandfathered” meaning purchased after PPACA law was put into effect. So let’s get down to the nitty gritty of preventive care and how to make it work for you and your family.
If your health insurance plan falls into the above mentioned category of “Non-Grandfathered” then you may be eligible to receive preventive services at NOT COST TO YOU: no copay, no coinsurance, no deductible. For example: Its flu season, and you want to get your seasonal flu vaccine. The corner drugstore advertises them for $25. However, vaccinations are included under the umbrella of preventive care. So call your Family Practitioner and schedule to go in just for the flu shot, making sure to tell the Doctor your primary reason of visit is for preventive care and not just an “Office Visit”. Want to know what else is included under the magical umbrella of Preventive Care? Thought you’d never ask:
Abdominal Aortic Aneurysm: one-time screening for men of specified ages 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 over 50
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
- Hepatitis B
- Herpes Zoster
- Human Papillomavirus
- Influenza
- Measles, Mumps, Rubella
- Meningococcal
- Pneumococcal
- Tetanus, Diphtheria, Pertussis
- 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
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
Breast Cancer Mammography: screenings every 1 to 2 years for women over 40
Breast Cancer Chemoprevention: counseling for women at higher risk
Breast Feeding interventions: to support and promote breast-feeding
Cervical Cancer: screening for sexually active women
Chlamydia Infection screening: for younger women and other women at higher risk
Folic Acid supplements: for women who may become pregnant
Gonorrhea screening: for all women at higher risk
Hepatitis B screening: for pregnant women at their first prenatal visit
Osteoporosis screening: for women over age 60 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
Syphilis screening: for all pregnant women or other women at increased risk
Covered Preventive Services for Children
Alcohol and Drug Use: assessments for adolescents
Autism screening: for children at 18 and 24 months
Behavioral assessments: for children of all ages
Cervical Dysplasia: screening for sexually active females
Congenital Hypothyroidism: screening for newborns
Developmental screening: for children under age 3, and surveillance throughout childhood
Dyslipidemia screening: for children at higher risk of lipid disorders
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
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
- Haemophilus influenzae type b
- Hepatitis A
- Hepatitis B
- Human Papillomavirus
- Inactivated Poliovirus
- Influenza
- Measles, Mumps, Rubella
- Meningococcal
- Pneumococcal
- Rotavirus
- 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
Obesity screening and counseling
Oral Health risk assessment for young children
Phenylketonuria (PKU) screening for this genetic disorder in newborns
Sexually Transmitted Infection (STI) prevention counseling for adolescents at higher risk
Tuberculin testing for children at higher risk of tuberculosis
Vision screening for all children