Under the Act affordable care (? also known as the ACA or Obamacare ), group health plans must cover certain preventive services without cost sharing any participant.
This provision is required under PHS in 2713 and is often called care or preventive services preventive requirement. This article describes preventive care rules ACA.
ACA preventive care requirements
Section 2713 the ACA requires private health plans to cover certain preventive services without cost sharing to participants in the form of co-insurance, deductibles, co-insurance, etc.
preventive care requirements are applicable to all private plans, non-grandfathered group health, including:
-
individual health insurance policies
-
small group health insurance policies
-
political large group health insurance
-
Self-insured plans, including medical reimbursement plans self-insured
Related: preventive care and employer Reimbursement of health insurance
List of mandatory preventive care services
The necessary preventive care services are divided into three categories :. adults, women (including pregnant women) and children
Preventive services covered for adults
-
aorta single abdominal screening for men age determined who have ever smoked
-
alcohol misuse screening and counseling
-
Aspirin use for men and women of certain ages
-
screening of blood pressure for all adults
-
cholesterol screening in adults of a certain age or high risk
-
colorectal cancer screening for adults over 50
-
screening depression for adults
-
type 2 diabetes screening for adults with high blood pressure
-
diet counseling for adults at high risk for chronic diseases
-
HIV testing for all adults at high risk
-
immunization vaccines for adults - doses, recommended ages, and recommended populations vary:
-
the obesity screening and counseling for all adult
-
sexually transmitted infection (STI) prevention counseling for adults at high risk
-
use tobacco screening for all adults and cessation interventions for tobacco users
-
screening syphilis for all adults at high risk
Preventive covered services for women, including pregnant women
-
screening of anemia regularly for pregnant women
-
bacteriuria urinary tract or other infection screening tests for pregnant women
-
BRCA counseling about genetic testing for high-risk women
-
breast cancer mammography screenings every 1 2 years for women over 40
-
Breast Cancer chemoprevention counseling for women at high risk
-
[supportcomplet breastfeeding and advice from qualified suppliers, and access to breastfeeding supplies for pregnant and lactating women
-
the Pap test among sexually active women
-
infection chlamydia screening in young women and other women at high risk
-
contraception methods Food and Drug administration-approved contraception, sterilization procedures, and patient education and counseling, as required by a healthcare professional for women with reproductive capacity (not including abortifacient drugs). This does not apply to health plans sponsored by certain exempt "religious employers".
-
domestic screening and interpersonal violence and counseling for all women
-
supplements folic acid for women who may become pregnant
-
screening pregnant women at gestational diabetes between 24 and 28 weeks high risk people to develop gestational diabetes
-
screening gonorrhea to all high-risk women
-
screening hepatitis B for pregnant women at their first prenatal visit
-
human immunodeficiency virus (HIV) screening and counseling for sexually active women
-
human papillomavirus (HPV) DNA testing
-
screening for osteoporosis women over 60 years based on risk factors
-
screening Rh Incompatibility for all pregnant women and follow-up testing for high-risk women
-
tobacco use screening and interventions for all women, and the Board expanded for pregnant tobacco users
-
sexually transmitted infections (STI) counseling for sexually active women *
-
syphilis testing for all women speakers or other women at increased risk
-
well-woman visits to obtain recommended preventive services *
Preventive services covered for children
-
alcohol and drug assessments for adolescents
-
autism screening for children 18 to 24 months
-
behavioral assessments for children of all ages
-
blood pressure screening for children
-
cervical dysplasia screening for sexually active women
-
screening for congenital hypothyroidism in newborns
-
screening adolescent depression
-
screening development for children under 3 years, and throughout childhood supervision
-
dyslipidemia screening for children at higher risk of lipid disorders
-
fluoride chemoprevention supplements for children without fluoride in their source water
-
gonorrhea preventive medication to the eyes of all newborns
-
Hearing screening for all newborns
-
height, weight and body mass index measurements for children
-
hematocrit or hemoglobin screening for children
-
hemoglobinopathies or screening for sickle cell for newborns
-
HIV testing for adolescents at higher risk
-
immunization vaccines for children birth at the age of 18 -doses, recommended ages, and recommended populations vary
-
iron supplements for children aged 6 to 12 months at risk of anemia
-
lead screening for children at risk of exposure
-
Medical History for all children through the development
-
the obesity screening and counseling
-
evaluation of oral health risk to young children
-
phenylketonuria (PKU) screening for this genetic disorder in newborns
-
sexually transmitted infection (STI) prevention tips and screening for higher risk adolescents
-
tuberculin test for children at high risk of TB
-
the visual screening for all children
Source - HHS
Conclusion
ACA requires all non-grandfathered group health plans to provide coverage for basic preventive care products and services without cost sharing for the patient or participant. Employers and their advisers can use this guide to understand the requirements for preventive care and to ensure compliance.
Additional Resources
-
DOL and HHS FAQ on preventive care requirements (11 May 2015)
-
KFF Slipsheet - preventive services covered by private health plans
-
preventive care and employers Refund health insurance
What questions do you have about the requirement for preventive care or affordable care Act? Leave a question below. We will help you to answer.
0 Komentar