Many people have some of the cost eased by getting health insurance coverage with a large employer that is either self-insured, or considered a large group.  While it’s nice to get help with the burden of the cost of insurance, many of these plans do not include some great Affordable Care Act provisions.  These provisions only apply to the individual major medical market or non-large group plans.  For the self employed or individuals that are on their own when it comes to purchasing a health insurance plan, it is important to know what your health insurance plan covers whether you have an existing policy or are looking for a new one.

The Affordable Care Act has made changes to health coverage that you may not be aware of.  If 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 your having to pay a copayment or co-insurance or meet your deductible. This applies only when these services are delivered by a network provider.

For children seeking preventative services, the following is fully covered:

  • Alcohol and Drug Use assessments for adolescents.
  • Autism screening for children at 18 and 24 months.
  • Behavioral assessments for children ages birth to 17 years.
  • Blood Pressure screening for children ages birth to 17 years.
  • 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 ages 1-17 years who are 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 ages birth to 17 years
  • Hematocrit or Hemoglobin screening for children
  • Hemoglobinopathies or sickle cell screening for newborns
  • HIV screening for adolescents at higher risk
  • 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  ages birth to 17 years throughout development
  • Obesity screening and counseling
  • Oral Health risk assessment for children ages birth to 10 years
  • Phenylketonuria (PKU) screening for this genetic disorder in newborns
  • Sexually Transmitted Infection(STI) prevention counseling and screening for adolescents at higher risk
  • Tuberculin testing for children  ages birth to 17 years at higher risk of tuberculosis.
  • Vision screening for all children
  • Immunization vaccines for  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