New health law ends out-of-pocket costs for many preventive services

By Carla K. Johnson, AP
Wednesday, September 22, 2010

Health law brings preventive care without copays

New health insurance policies beginning on or after Sept. 23 must cover — without charge — preventive care that’s backed up by the best scientific evidence. Most people will see this benefit, part of the Obama administration’s health care overhaul, starting Jan. 1.

The list includes tests strongly recommended by the U.S. Preventive Services Task Force, an independent advisory panel that evaluates research.

Of note for men: Screening for prostate cancer isn’t included on the list because its benefits haven’t been conclusively shown by the best research, at least to the high level required by the law.

Of note to women: Those in their 40s and at average risk for breast cancer can get a mammogram every one to two years as part of the free preventive care. That’s in line with American Cancer Society advice. But it’s more generous than the Preventive Services Task Force, which says most women don’t need mammograms in their 40s.

Many employer-based plans won’t be affected by these new requirements if they are “grandfathered” under the health overhaul law. But as those plans make substantial changes they’ll lose their grandfathered status and then have to meet the requirements.

Here are some of the preventive services that many people won’t have to pay for out-of-pocket, according to federal health officials.

For adults:

—Abdominal aortic aneurysm one-time screening for men of certain ages who have ever smoked.

—Alcohol misuse screening and counseling.

—Blood pressure screening.

—Cholesterol screening for adults of certain ages or at higher risk.

—Colorectal cancer screening for adults over 50.

—Depression screening.

—Type 2 diabetes screening for adults with high blood pressure.

—Obesity screening and counseling.

—Diet counseling for adults at higher risk for chronic disease.

—Certain vaccines for adults, such as flu shots.

—Sexually transmitted infection prevention counseling for adults at higher risk.

—Tobacco use screening for all adults and cessation interventions for tobacco users.

—HIV and syphilis screening for adults at higher risk.

For women:

—Anemia screening on a routine basis during pregnancy.

—Bacteriuria urinary tract or other infection screening during pregnancy.

—BRCA counseling about genetic testing for women at higher risk.

—Breast cancer mammograms every one to two years for women over 40.

—Breast cancer chemoprevention counseling for women at higher risk.

—Interventions to support and promote breast feeding.

—Cervical cancer screening for sexually active women.

—Chlamydia screening for younger women and other women at higher risk.

—Folic acid supplements for women who may become pregnant.

—Gonorrhea screening for 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.

—Expanded counseling for pregnant tobacco users.

—Syphilis screening for pregnant women or other women at increased risk.

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 supplements for children without fluoride in their drinking water.

—Gonorrhea preventive medication for the eyes of all newborns.

—Hearing screening for all newborns.

—Height, weight and body mass index measurements.

—Hematocrit or hemoglobin screening.

—Hemoglobinopathies or sickle cell screening for newborns.

—HIV screening for adolescents at higher risk.

—Vaccines for children from birth to age 18.

—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 screening for the genetic disorder in newborns.

—Sexually transmitted infection prevention counseling for adolescents at higher risk.

—Tuberculin testing for children at higher risk.

—Vision screening.

Online:

www.healthcare.gov/law/about/provisions/services/lists.html

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