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California health insurance  -  Understand health insurance in California  -  Health plan preventative benefits

Preventive Care and California health insurance

Preventative benefits have changed significantly since 3/23/2010.

 We always had preventative benefits as part of most health insurance plans but there was generally some cost sharing involved. Preventative benefits are now covered at 100% on all newer plans (effective dates after 3/23/2010).

This is a big change.

There was a follow up enhancement of the original list of benefits for woman preventative services. Let's look at a general outline of preventative benefits that might be available through your California health insurance although you should always double check your policy.

Preventative benefit changes

Preventive physical exams for children up to age 18.
 Screening tests, assessments, and counseling including:
 Eye chart vision screening
 Hearing screening
 Oral health assessment
 Lead exposure screening
 Anemia screening
 Tuberculosis screening
 Pelvic exam and Pap test
 Newborn screenings

 
 Developmental and behavioral assessments

 Cholesterol and lipid level screening
 Depression screening
 
 Obesity screening and counseling
 
 Behavioral counseling to promote a healthy diet
 
 Sexually transmitted infections screening
 

Immunizations including:
 Hepatitis A
 Hepatitis B

 Diphtheria, Tetanus, Pertussis (DtaP)
 Varicella (chicken pox)
 Influenza (flu shot)

Pneumococcal Conjugate (pneumonia)
Human Papilloma Virus (HPV)
H. Influenza type b (Hib)
Polio
Measles, Mumps, Rubella (MMR)
Meningococcal Polysaccharide

Rotavirus
Adult Preventative Benefits:
Preventive physical exams

Screening tests including:
Eye chart vision screening
Hearing screening
Cholesterol and lipid level screening
Diabetes screening

Prostate cancer screenings including digital rectal exam and PSA test
Breast exam, breast cancer screening, including mammography
 
Pelvic exam and Pap test

Sexually transmitted infections screening

HIV test

Bone density test to screen for osteoporosis
Colorectal cancer screening including fecal occult blood test, barium enema, flexible sigmoidoscopy and screening colonoscopy
 
Aortic Aneurysm screening

Certain pregnancy screenings, including but not limited to:

Hepatitis
Asymptomatic bacteriuria
Rh incompatibility
Syphilis
Iron deficiency anemia
Gonorrhea
Chlamydia
Intervention screening, counseling and education including:
Screening and counseling for obesity
 
Counseling related to genetic testing for breast and ovarian cancer
Behavioral counseling to promote a healthy diet
 
Primary care intervention to promote breastfeeding
Counseling related to aspirin use for the prevention of cardiovascular disease
Screening and behavioral counseling related to tobacco use and tobaccocaused disease
Screening and behavioral counseling related to alcohol use

Immunizations Including:

Hepatitis A
Hepatitis B (expanded codes)
Tetanus, Diphtheria (Td)
Varicella (chicken pox)
Influenza (flu shot) (expanded codes)
Pneumococcal Conjugate (pneumonia)
Human Papilloma Virus (HPV)
Measles, Mumps, Rubella (MMR)
Meningococcal Polysaccharide
Herpes Zoster (shingles)


Resources

Agency for Healthcare Research and Quality
Government agency with Personal Health Guides to routine care
1-800-358-9295
www.ahrq.gov
California Smoker's Helpline
Telephone and online help to stop smoking
1-800-662-8887
www.californiasmokershelpline.org
Lab Tests Online
Information about lab tests
www.labtestsonline.org
National Immunization Hotline
Government agency with a guide to vaccines for children and adults
1-800-232-2522
1-888-232-6348 (TTY)
www.cdc.gov/nip
Obesity and Overweight
Information on obesity and chart to check Body Mass Index (BMI)
www.cdc.gov/nccdphp/dnpa/bmi/calc-bmi.htm


 

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