Preventative Care Benefits for Adults

The Affordable Care Act has guidelines for Preventative Care for women, children, and adults.   Preventative Care must be offered with all healthcare plans whether you purchase the plan through the Marketplace ( or directly through the insurance company.   These benefits must cover these benefits without charging you a co-pay or co-insurance.   This is true even if you have yet to meet your yearly deductible.    The insurance company will require you to use an in network provider for these services.   If you use an out of network provider, there will be a charge even if the services are preventative.

In the last few weeks, Balanced Care has provided information on the preventative benefits that must be covered for both women and children.    Today, it is all about adults.   The following is a list of preventative services that must be covered for every adult:

  • Abdominal Aortic Aneurysm one time screening – For men of specified ages who have ever smoked
  • Alcohol misuse screening and counseling
  • Aspirin Use – For prevention of Cardiovascular disease for men and women of certain ages
  • Blood pressure screening for all adults
  • Cholesterol screening for adults of certain ages or at higher risk
  • Colorectal Cancer Screening for adults over age 50
  • Depression screening for adults
  • Diabetes screening (Type 2) for adults with high blood pressure
  • Diet counseling for adults at higher risk of chronic disease
  • HIV screening for everyone ages 15 – 65, and other ages at increased risk
  • Obesity screening and counseling for all adults
  • Sexually transmitted infection (STI) for adults at higher risk
  • Syphilis screening for all adults at higher risk
  • Tobacco use screening for all adults and cessation interventions for tobacco users

Immunizations for adults are also considered preventative care and include:

  • Hepatitis A
  • Hepatitis B
  • Herpes Zoster
  • Human Papillomavirus
  • Influenza (Flu shot)
  • Measles, Mumps, and Rubella
  • Meningococcal
  • Pneumococcal
  • Tetanus, Diphtheria, Pertussis
  • Varicella

Preventative Care is an important step in your health and well being.   If you have questions regarding your current health plan or need information on your coverage, Balanced Care is here is help. We encourage and welcome your questions and look forward to being your trusted advisor and consultant.    Give us a call or feel free to use our no obligation, “Get A Quote” button today.


512803HBW_LogoTerri Trepanier is the owner of Balanced Care Health and Supplemental Insurance and a licensed broker in Maine and New Hampshire.  Her specialty is working with small businesses, individuals, and families with their health and life insurance needs.  She is certified to offer health plans both on and off the exchange and is contracted with every health insurance company that offers plans in both New Hampshire and Maine.  Her other passion is assisting Medicare beneficiaries with their Medicare Supplemental, Medicare Part D Prescription Drug Plans, and Medicare Advantage plans. Terri has seen firsthand the importance of insurance products and how they help families.  Her goal with Balanced Care is to “Insure Security and Peace of Mind One Family at a Time”.

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