Is preventive care covered?

“The Affordable Care Act will help make wellness and prevention services affordable and accessible to you by requiring health plans to cover preventive services and by eliminating cost-sharing. According to a new regulation released by the Department of Health and Human Services, the Department of Treasury and the Department of Labor, if you or your family enroll in a new health plan on or after September 23, 2010, then that plan will be required to cover recommended preventive services without charging you a copay, co-insurance or deductible.”

“[T]he Prevention and Public Health Fund [of the Patient Protection and Affordable Care Act] invests in proven strategies that prevent people from getting sick in the first place — and that save lives and money down the road. It funds community-based programs that help people who use tobacco (our nation’s leading preventable cause of death) to quit and prevent others from starting. It supports initiatives to reduce diabetes and heart disease, strengthen breast and colon cancer screenings, and provide adult vaccine programs.

Being healthy starts long before you need a doctor, and achieving the best health starts in our homes, workplaces and schools. Thanks to this prevention fund, money is already at work in our communities, helping to transform neighborhoods and making it easier for us to choose healthy lifestyles…

Fortunately, health reform provides us the opportunity to reshape the way we care for ourselves by not only expanding access to health services but shifting away from our ‘sick care’ system.”

“Starting in October [2010], new private health plans will be required to cover preventive care and screenings that are recommended by the U.S. Preventive Services Task Force at no charge, including vaccinations and cancer screenings.

Next year, seniors will be able to receive annual check-ups and recommended screenings without having to share in the costs. They’ll be offered personalized prevention plans that take their health risks into account.

There are very specific provisions for certain groups. Pregnant women who are on Medicaid must be provided smoking cessation counseling and drug therapy, for instance.

…[S]tarting in 2014 the new law will allow employers to offer premium discounts and other incentives of up to 30 percent of the cost of employees’ health coverage (and up to 50 percent in some instances) if workers participate in wellness programs and meet health targets. Current law permits discounts of only 20 percent.”

“In 2011, cost-sharing for proven preventive services will be eliminated in Medicare and Medicaid. Medicare payments for certain preventive services will be increased to 100 percent of payment schedule rates (that is, co-payments will be eliminated), and incentives will be available to encourage Medicare and Medicaid beneficiaries to complete behavior modification programs.

In the private sector, beginning in 2010, health plans will be required to provide a minimum level of coverage without cost-sharing for preventive services such as immunizations, preventive care for infants, children and adolescents, and additional preventive care and screenings for women.”