The Free Services Obamacare Says You Should Be Getting

Occupy Wall Street supporters march calling for universal healthcare in New York, October 26, 2011. Physicians, nurses, community groups and supporters of healthcare marched to call for an end of corporate greed in the health insurance industry. Photo by Emmanuel Dunand/AFP/Getty Images

Emmanuel Dunand/AFP/Getty Images

Considering how expensive American health care has become, it’s worth taking advantage of the many free health services available. The Affordable Care Act (ACA) guarantees certain patient rights and protections, including free screenings, vaccines, and other forms of preventive care. Most health plans, including marketplace private insurance plans, are required to fully cover a set of preventive services. These health care services should be provided to you without a copay or coinsurance, even if you haven’t met your yearly deductible. However, for many plans, these services must be done in-network to avoid cost sharing.

Grandfathered plans

Your legal right to free preventive health care, newly granted by the ACA, doesn’t apply to health plans created or bought before March 23, 2010, also known as grandfathered plans. To find out if your health plan is grandfathered, ask your employer or benefits administrator. If you don’t have health insurance or your plan doesn’t cover essential health benefits and free preventive services, check out your state’s health insurance marketplace at healthcare.gov.

Medicaid and Medicare

If you are on Medicaid, unfortunately it is likely that some of the free preventive health services guaranteed to those with private insurance will not be available to you, depending on the state you live in. Also, because the ACA treats existing and newly eligible Medicaid beneficiaries differently, all adult Medicaid beneficiaries within a state might not be eligible for the same free preventive services. For seniors, the Medicare program provides its own list of free preventive services.

The Hobby Lobby case

On June 30, 2014, Supreme Court justices ruled in favor of Hobby Lobby, concluding that closely held for-profit companies couldn’t be forced to cover the cost of contraception in their employees’ health plans if doing so would conflict with the company owners’ religious beliefs. In response to the ruling, the Obama administration asked that employers fill out a form, outlining their objection and the name of the plan’s insurer, and send it to the government so the contraception costs could then be fully covered by the insurer. This arrangement was challenged by the University of Notre Dame, but as the courts continue to fight out the details, women working for religious employers may still have contraceptive costs covered in full, though there are no guarantees. According to a report from the Guttmacher Institute, the specifics of the religious employer exemption can also vary by state.

(Note: There are exceptions for contraception coverage in addition to the religious employer exemption outlined above. For example, name-brand contraceptives, as opposed to generics, are not covered by certain plans, and some insurers will require a prescription before providing coverage, even for over-the-counter emergency contraceptives.)

Expanded access to preventive care

Just days before the Hobby Lobby ruling, the U.S. Department of Health & Human Services announced that 76 million Americans with private health insurance plans became newly eligible to receive expanded access to free preventive health care services. The report’s findings were especially promising for women. An additional 24.4 million prescriptions for oral contraceptives were dispensed with no co-pays in 2013 compared to 2012, according to IMS Institute for Healthcare Informatics (IMS). That means an estimated $483.3 million reduction in out-of-pocket spending by women.

If, like so many Americans, you’re tired of the high cost of medical care, take solace in the many preventive health services that insured patients can receive at no cost. The following information was provided by healthcare.gov.

Source: Thinkstock

Source: Thinkstock

Free preventive services for all adults

  • 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
    • 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
  • Syphilis screening for all adults at higher risk
  • Tobacco Use screening for all adults and cessation interventions for tobacco users

Source: Thinkstock

Source: Thinkstock

Free preventive services for adult women

  • Breast Cancer Genetic Test Counseling (BRCA) for women at higher risk for breast cancer
  • Breast Cancer Mammography screenings every 1 to 2 years for women over 40
  • Breast Cancer Chemoprevention counseling for women at higher risk
  • 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, as prescribed by a health care provider for women with reproductive capacity (not including abortifacient drugs). This does not apply to health plans sponsored by certain exempt “religious employers.”
  • Domestic and interpersonal violence screening and counseling for all women
  • Folic Acid supplements for women who may become pregnant
  • Gonorrhea screening for all women at higher risk
  • HIV screening and counseling for sexually active women
  • Human Papillomavirus (HPV) DNA Test every 3 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
  • Sexually Transmitted Infections counseling for sexually active women
  • Syphilis screening for all pregnant women or other women at increased risk
  • Tobacco Use screening and interventions for all women, and expanded counseling for pregnant tobacco users
  • Well-woman visits to get recommended services for women under 65

Source: Thinkstock

Source: Thinkstock

Free preventive services for pregnant women

  • Anemia screening on a routine basis for pregnant women
  • Breastfeeding comprehensive support and counseling from trained providers, and access to breastfeeding supplies, for pregnant and nursing women
  • Gestational diabetes screening for women 24 to 28 weeks pregnant and those at high risk of developing gestational diabetes
  • Hepatitis B screening for pregnant women at their first prenatal visit
  • Rh Incompatibility screening for all pregnant women and follow-up testing for women at higher risk
  • Syphilis screening for all pregnant women or other women at increased risk
  • Tobacco Use screening and interventions for all women, and expanded counseling for pregnant tobacco users
  • Urinary tract or other infection screening for pregnant women

vaccine doctor child pediatrician Getty Images

Source: Getty Images

Free preventive services for children

  • Alcohol and Drug Use assessments for adolescents
  • Autism screening for children at 18 and 24 months
  • Behavioral assessments for children at the following ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years.
  • Blood Pressure screening for children at the following ages: 0 to 11 months, 1 to 4 years , 5 to 10 years, 11 to 14 years, 15 to 17 years.
  • Cervical Dysplasia screening for sexually active females
  • Depression screening for adolescents
  • Developmental screening for children under age 3
  • Dyslipidemia screening for children at higher risk of lipid disorders at the following ages: 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years.
  • 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 at the following ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years.
  • Hematocrit or Hemoglobin screening for children
  • Hemoglobinopathies or sickle cell screening for newborns
  • HIV screening for adolescents at higher risk
  • Hypothyroidism screening for newborns
  • 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
    • 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 at the following ages: 0 to 11 months, 1 to 4 years , 5 to 10 years , 11 to 14 years , 15 to 17 years.
  • Obesity screening and counseling
  • Oral Health risk assessment for young children ages: 0 to 11 months, 1 to 4 years, 5 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 at higher risk of tuberculosis at the following ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years.
  • Vision screening for all children

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