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The Health Insurance Marketplace: Preventive Care Benefits

Most health plans must cover a set of preventive services like shots and screening tests at no cost to you. This includes Marketplace private insurance plans. Preventive care helps you stay healthy. A doctor isn't someone to see only when you're sick. Doctors also provide services that help keep you healthy.

All Marketplace plans, and many other plans, must cover the following list of preventive services without charging you a copayment or coinsurance. This is true even if you haven't met your yearly deductible. This applies only when these services are delivered by a network provider.

  • Abdominal aortic aneurysm one-time screening for men of specified ages who have ever smoked
  • Alcohol misuse screening and counseling
  • Aspirin use to prevent cardiovascular disease 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
  • Diabetes (Type 2) screening for adults with high blood pressure
  • Diet counseling for adults at higher risk for chronic disease
  • HIV screening for everyone ages 15 to 65, and other ages at increased risk
  • Immunization vaccines for adults (doses, recommended ages, and recommended populations vary)
    • Hepatitis A
    • Hepatitis B
    • Herpes zoster (shingles)
    • Human papillomavirus
    • Influenza (flu shot)
    • Measles, mumps, and rubella
    • Meningococcal
    • Pneumococcal
    • Tetanus, diphtheria, and pertussis
    • Varicella
  • Obesity screening and counseling for all adults
  • Sexually transmitted infection (STI) prevention counseling for adults at higher risk
  • Syphilis screening for all adults at higher risk
  • Tobacco use screening for all adults and cessation interventions for tobacco users

U.S. Centers for Medicare & Medicaid Services, HealthCare.gov. (n.d.). What are my preventive care benefits? Retrieved May 16, 2017, from https://www.healthcare.gov/

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