Health Center - Health Care Reform

Health care coverage is important for all Americans, and the Affordable Care Act will significantly change the type of coverage we have and access to that coverage. Learn more here about expansion of covered preventive services, an end to lifetime limits, reduced barriers due to preexisting conditions, mandated coverage for all Americans and other changes that may affect you and your loved ones.

Preventive Services Covered Under the Affordable Care Act

team of health care professionalsIf you have a new health insurance plan or insurance policy beginning on or after September 23, 2010, the following preventive services must be covered without you being required to pay a co-payment or coinsurance or meet your deductible. This applies only when these services are delivered by a network provider.

Covered Preventive 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 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 (flu shot)
    • 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 one to two years for women over 40
  • 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 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
  • Sexually transmitted infections (STIs): 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*

* Must be covered with no cost-sharing in plan years starting on or after August 1, 2012.

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
  • Blood pressure: screening for children
  • 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
  • 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 (flu shot)
    • 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 infections (STIs): prevention counseling and screening for adolescents at higher risk
  • Tuberculin: testing for children at higher risk of tuberculosis
  • Vision: screening for all children

To find out more, you may want to read:

Major Changes With Health Care Reform
More Options for Purchasing Insurance
Insurance Regulation Changes That May Affect You
A Perspective on Women and Health Care
Timeline for Health Care Reform Changes
Health Care Reform: Where to Learn More
Ask the Expert: How does the new health care reform act affect older women?
Ask the Expert: How do the new health reform laws affect low-income women?