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Q: Will preventive services such as routine vaccines and mammograms be covered under health reform?

A: Yes, health reform will make it easier for people to get timely preventive services that they need in order to stay healthy. If you have a private insurance plan that was purchased (by you or your employer) on or after March 23, 2010, then that plan will be required to cover recommended preventive services without charging you copayments, deductibles, or other cost-sharing when you see an in-network provider.

For health plan years starting on or after September 23, 2010, a broad array of preventive services must be covered without cost-sharing. Here are some of the highlights:

  • Cholesterol and blood pressure tests at recommended ages;
  • Cancer screenings, including mammograms and colon cancer screenings, at recommended ages;
  • Routine vaccines and immunizations recommended by the Centers for Disease Control and Prevention;
  • Women’s health screenings including pap smears; and
  • Screenings for children and newborns, such as hearing and vision tests at recommended ages.

These are not all of the preventive services that new plans required to cover. To see the complete list of recommendations and guidelines, visit: www.healthcare.gov/center/regulations/prevention.html.

In addition, to learn more about this new right to preventive services in private health plans under health reform and other protections that take effect starting on September 23rd, take a look at Families USA’s new fact sheets highlighting these protections and also check out our interactive virtual patients.

Christine Sebastian is a Health Policy Analyst at Families USA, a nonprofit, nonpartisan organization striving to achieve quality, affordable health coverage for all Americans. For more information, visit www.familiesusa.org.


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