Preventive care helps keep you healthy and out of the hospital. We want to help you and your primary care provider prevent and manage health problems before you feel sick or are disabled. After all, members are our lifeblood. So the healthier our members are, the healthier the CO-OP is!
Under the Affordable Care Act, health insurance plans must cover certain preventive services without charging you a co-payment or coinsurance. This is true even if you haven’t met your yearly deductible. This applies only when you receive these services by an in- network provider. What types of preventive care and services are available?
Below is the list of preventive services your plan covers for Children and Teens or Adults at zero cost to you:
Preventive Health Services for Children and Teens
| Alcohol and Drug Use Assessments | Adolescents |
| Autism Screening | 18 and 24 months |
| Behavioral Assessments | 0-11 months, 1-4 years, 5-10 years, 11-14 years, 15-17 years |
| Blood Pressure Screenings | 0-11 months, 1-4 years, 5-10 years, 11-14 years, 15-17 years |
| Cervical Dysplasia (Pap Test) | Sexually active females |
| Depression Screening | Adolescents |
| Developmental Screening | Under age 3 |
| Dyslipidemia Screening for children at higher risk of lipid disorders | 0-11 months, 1-4 years, 5-10 years, 11-14 years, 15-17 years |
| Fluoride Supplements | For children from either dentist or primary care provider |
| Gonorrhea preventive medication | For the eyes of all newborns |
| Hearing Screening | All newborns |
| Height, Weight and Body Mass Index (BMI) | 0-11 months, 1-4 years, 5-10 years, 11-14 years, 15-17 years |
| Hematocrit or Hemoglobin Screening | Children |
| Hemoglobinopathies Screening | Sickle Cell Newborns |
| HIV Screening | Adolescents at risk |
| Hypothyroidism Screening | Newborns |
| Immunizations Diphtheria, Tetanus, Pertussis; Haemophilus influenzae type b; Hepatitis A and B; Human Papillomavirus (HPV); Inactivated Poliovirus; Influenza (Flu Shot); Measles; Meningococcal; Pneumococcal; Rotavirus; Varicella |
Please visit www.cdc.gov/vaccines/schedules/ for immunization schedules by age. |
| Iron Supplements | Children ages 6 – 12 months at risk for anemia |
| Lead Screening | Children at risk of exposure |
| Medical History | 0-11 months, 1-4 years, 5-10 years, 11-14 years, 15-17 years |
| Obesity Screening and Counseling | Children |
| Oral Health Assessment | 0 – 11 months, 1 – 4 years, 5 – 10 years |
| Phenylketonuria Screening PKU | Newborns |
| Sexually Transmitted Infection (STI) Screening and Counseling | Adolescents at risk |
| Tuberculin Testing | 0-11 months, 1-4 years, 5-10 years, 11-14 years, 15-17 years |
| Vision Screening(not a complete eye exam) | Children |
Preventive Health Services for Adults
| Abdominal Aortic Aneurysm One-Time Screening | Men age 65 – 75 who have ever smoked |
| Alcohol Misuse Screening and Counseling | All adults |
| Anemia Screening | Pregnant women |
| Aspirin Use to prevent cardiovascular disease | Men age 45 – 79 and women age 55 – 79 |
| Blood Pressure Screening | All adults |
| Breast Cancer Genetic Test Counseling (BRCA) | Women at higher risk |
| Breast Cancer Mammography Screenings | Every 1 to 2 years for women over 40 |
| Breast Cancer Chemoprevention Counseling | Women at higher risk |
| Breastfeeding Comprehensive Support and Counseling | Pregnant and nursing women |
| Cervical Cancer screening | Pap Test Sexually active women |
| Chlamydia Infection Screening | Sexually active women |
| Cholesterol Screening | Men ages 35 and older, or under 35 if risk factors; women age 20 and older at risk of heart disease |
| Colorectal Cancer Screening | Adults over age 50 |
| Contraception | All women |
| Depression Screening | All adults |
| Diabetes Screening – Type 2 | Adults with high blood pressure |
| Diet Counseling | Adults at risk for chronic disease |
| Domestic and Interpersonal Violence Screening and Counseling | All women |
| Folic Acid (Prenatal Vitamins) | Women who may become pregnant |
| Gestational Diabetes Screening | Women 24 – 28 weeks pregnant; and those at risk of developing |
| Gonorrhea Screening | Sexually active women |
| Hepatitis B screening | Pregnant women |
| HIV Screening and Counseling | Everyone age 15 – 65, and other ages at increased risk |
| Human Papillomavirus (HPV) DNA Test | Woman ages 30 – 65 every 3 years |
| Immunizations Hepatitis A and B; Herpes Zoster; Human Papillomavirus (HPV); Influenza (Flu Shot); Measles, Mumps, Rubella; Meningococcal; Pneumococcal; Tetanus, Diphtheria, Pertussis; Varicella | Please visit www.cdc.gov/vaccines for immunization schedules |
| Obesity Screening and Counseling | All adults |
| Osteoporosis Screening | Women over age 60 |
| Rh Incompatibility Screening | Pregnant women; at risk |
| Sexually Transmitted Infection (STI) Screening and Prevention | All adults |
| Counseling | |
| Syphilis Screening | Pregnant women and adults |
| Tobacco Use Screening and Interventions | All adults and cessation interventions for tobacco users |
| Urinary Tract or Other Infection Screening | Pregnant women |
| Well-Woman Visits | Women under age 65 |
Why we’re big on preventive care
Our goal is to help prevent or detect issues early, before you have complications that could land you in the hospital and have a bigger impact your wallet. That’s why we don’t just want you to access free preventive health services. Routine checkups and screenings with your primary care provider are important. They can help you find potential health concerns early. And that can make a big difference in being able to effectively manage health conditions.