Information About Health Coverage Preventive care benefits

Preventive care benefits for children

Most health plans must cover a set of preventive health services for children at no cost when delivered by an in-network provider. This includes Marketplace and Medicaid coverage.

IMPORTANT These services are free only when delivered by a doctor or other provider in your plan’s network.

Coverage for children’s preventive health services

All Marketplace health plans and many other plans must cover the following list of preventive services for children without charging you a copayment or coinsurance. This is true even if you haven’t met your yearly deductible.

  1. Alcohol and Drug Use assessments for adolescents
  2. Autism screening for children at 18 and 24 months
  3. 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.
  4. 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.
  5. Cervical Dysplasia screening for sexually active females
  6. Depression screening for adolescents
  7. Developmental screening for children under age 3
  8. 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.
  9. Fluoride Chemoprevention supplements for children without fluoride in their water source
  10. Gonorrhea preventive medication for the eyes of all newborns
  11. Hearing screening for all newborns
  12. 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.
  13. Hematocrit or Hemoglobin screening for children
  14. Hemoglobinopathies or sickle cell screening for newborns
  15. Hepatitis B screening for adolescents at high risk, including adolescents from countries with 2% or more Hepatitis B prevalence, and U.S.-born adolescents not vaccinated as infants and with at least one parent born in a region with 8% or more Hepatitis B prevalence: 11 – 17 years.
  16. HIV screening for adolescents at higher risk
  17. Hypothyroidism screening for newborns
  18. Immunization vaccines for children from birth to age 18 —doses, recommended ages, and recommended populations vary:
  19. Iron supplements for children ages 6 to 12 months at risk for anemia
  20. Lead screening for children at risk of exposure
  21. 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.
  22. Obesity screening and counseling
  23. Oral Health risk assessment for young children Ages: 0 to 11 months, 1 to 4 years, 5 to 10 years.
  24. Phenylketonuria (PKU) screening for this genetic disorder in newborns
  25. Sexually Transmitted Infection (STI) prevention counseling and screening for adolescents at higher risk
  26. 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.
  27. Vision screening for all children.
 
 

Learn more about preventive care from the (Centers for Disease Control and Prevention).

More information about preventive services for children

More on prevention

 
 

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