Prevention

Health Prevention

Prevention in health terms pertains to strategies and measures that aim to reduce the likelihood of diseases, injuries, or illnesses. Such preventive measures can be diagnostic, like a colonoscopy performed to detect the early stages of colon cancer, or protective, such as immunizations. Regular screenings for various potential health issues are a cornerstone of preventive healthcare.

Examples of Preventive Measures

Adults

For adults, preventive services often include screenings for:

• Blood pressure
• Various forms of cancer
• Cholesterol
• Depression
• Obesity
• Type 2 diabetes

Children

For children, preventive care usually involves screenings for:

• Hearing impairments
• Vision impairments
• Autism and developmental disorders
• Depression
• Obesity

U.S. Preventive Services Legislation

In the United States, the Affordable Care Act of 2010 (often referred to as the ACA) played a pivotal role in expanding preventive healthcare services. The act made significant strides in ensuring wider accessibility to preventive services.

Mandated Coverage

The ACA mandates that health insurances in the marketplace provide coverage for preventive services without the imposition of copays, deductibles, or additional charges. Specifically, there are 63 distinct preventive services that insurers are obliged to cover without passing costs to the enrollee.

Implementation Timeline

While this provision of no-cost preventive services began in September 2010 for some newly introduced health plans, it witnessed a more expansive implementation from January 1, 2014. The provision now applies to plans in the individual, small, and select large group markets. However, exceptions exist, primarily for some grandfathered employer plans and policies acquired by individuals exempted from the ACA's coverage mandate.

Network Provider Requirement

For commercial health insurance, both inside and outside of health exchanges, it's essential to note that the no-cost feature for preventive services applies only when availed from a network provider.

Preventive Services For Adults

The following measures are some of the preventive health and screening services recommended.

• Abdominal aortic aneurysm one-time screening for men of specified ages who have ever smoked
• Alcohol misuse screening and counseling
• Aspirin use to prevent cardiovascular disease and colorectal cancer for adults 50 to 59 years with a high cardiovascular risk
• Blood pressure screening
• Cholesterol screening for adults of certain ages or at higher risk
• Colorectal cancer screening for adults 50 to 75
• Depression screening
• Diabetes (Type 2) screening for adults 40 to 70 years who are overweight or obese
• Diet counseling for adults at higher risk for chronic disease
• Falls prevention (with exercise or physical therapy and vitamin D use) for adults 65 years and over, living in a community setting
• Hepatitis B screeningThis link takes you to a website not operated by the federal government. The site may have different privacy and security policies. for people at high risk, including people from countries with 2% or more Hepatitis B prevalence, and U.S.-born people not vaccinated as infants and with at least one parent born in a region with 8% or more Hepatitis B prevalence.
• Hepatitis C screening for adults at increased risk, and one time for everyone born 1945–1965
• HIV screening for everyone ages 15 to 65, and other ages at increased risk

Immunization vaccines for adults — doses, recommended ages, and recommended populations vary:

• Diphtheria
• Hepatitis A
• Hepatitis B
• Herpes Zoster
• Human Papillomavirus (HPV)
• Influenza (flu shot)
• Measles
• Meningococcal
• Mumps
• Pertussis
• Pneumococcal
• Rubella
• Tetanus
• Varicella (Chickenpox)
• Lung cancer screeningThis link takes you to a website not operated by the federal government. The site may have different privacy and security policies. for adults 55-80 at high risk for lung cancer because they’re heavy smokers or have quit in the past 15 years
• Obesity screening and counseling
• Sexually transmitted infection (STI) prevention counseling for adults at higher risk
• Statin preventive medication for adults 40 to 75 at high risk
• Syphilis screening for adults at higher risk
• Tobacco use screening for all adults and cessation interventions for tobacco users
• Tuberculosis screening for certain adults without symptoms at high risk

Preventive services for women

Services for pregnant women or women who may become pregnant

• Anemia screening on a routine basis
• Breastfeeding comprehensive support and counseling from trained providers, and access to breastfeeding supplies, for pregnant and nursing women
• Contraception: Food and Drug Administration-approved contraceptive methods, sterilization procedures, and patient education and counseling, as prescribed by a health care provider for women with reproductive capacity (not including abortifacient drugs). This does not apply to health plans sponsored by certain exempt “religious employers.” Learn more about contraceptive coverage.
• Folic acid supplements for women who may become pregnant
  
• Gestational diabetes screening for women 24 to 28 weeks pregnant and those at high risk of developing gestational diabetes
• Gonorrhea screening for all women at higher risk
• Hepatitis B screening for pregnant women at their first prenatal visit
• Preeclampsia prevention and screening for pregnant women with high blood pressure
  
• Rh incompatibility screening for all pregnant women and follow-up testing for women at higher risk
  
• Syphilis screening
• Expanded tobacco intervention and counseling for pregnant tobacco users
  
• Urinary tract or other infection screeningOther covered preventive services for women

More preventive services for women

• Breast cancer genetic test counseling (BRCA) for women at higher risk
• Breast cancer]] mammography screenings every 1 to 2 years for women over 40
• Breast cancer chemoprevention counseling for women at higher risk
• Cervical cancer screening
• Pap test (also called a Pap smear) every 3 years for women 21 to 65
• Human Papillomavirus (HPV) DNA test with the combination of a Pap smear every 5 years for women 30 to 65 who don’t want a Pap smear every 3 years
• Chlamydia infection screening for younger women and other women at higher risk
• Diabetes screening for women with a history of gestational diabetes who aren’t currently pregnant and who haven’t been diagnosed with type 2 diabetes before
• Domestic and interpersonal violence screening and counseling for all women
• Gonorrhea screening for all women at higher risk
• HIV screening and counseling for sexually active women
• Osteoporosis screening for women over age 60 depending on risk factors
• Rh incompatibility screening follow-up testing for women at higher risk
• Sexually transmitted infections]] counseling for sexually active women
• Syphilis]] screening for women at increased risk
• Tobacco use screening and interventions
• Urinary incontinence screening for women yearly
• Well-woman visits to get recommended services for women under 65

Preventive services for Children

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.

• Alcohol, tobacco, and drug use assessments for adolescents
• Autism screening for children at 18 and 24 months
• Behavioral assessments for children ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years
• Bilirubin concentration screening for newborns
• Blood pressure screening for children ages: 0 to 11 months, 1 to 4 years , 5 to 10 years, 11 to 14 years, 15 to 17 years
• Blood screening for newborns
• Cervical dysplasia screening for sexually active females
• Depression screening for adolescents beginning routinely at age 12
• Developmental screening for children under age 3
• Dyslipidemia screening for all children once between 9 and 11 years and once between 17 and 21 years, and for children at higher risk of lipid disorders ages: 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years
• Fluoride chemoprevention supplements for children without fluoride in their water source
• Fluoride varnish for all infants and children as soon as teeth are present
• Gonorrhea preventive medication for the eyes of all newborns
• Hearing screening for all newborns; and for children once between 11 and 14 years, once between 15 and 17 years, and once between 18 and 21 years
• Height, weight and body mass index (BMI) measurements for children ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years
• Hematocrit or hemoglobin screening for all children
• Hemoglobinopathies or sickle cell screening for newborns
• Hepatitis B screeningThis link takes you to a website not operated by the federal government. The site may have different privacy and security policies. 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
• HIV screening for adolescents at higher risk
• Hypothyroidism screening for newborns

Immunization vaccines for children from birth to age 18 — doses, recommended ages, and recommended populations vary:

• Diphtheria, Tetanus, Pertussis (Whooping Cough)
• Haemophilus influenza type b
• Hepatitis A
• Hepatitis B
• Human Papillomavirus (HPV)
• Inactivated Poliovirus
• Influenza (flu shot)
• Measles
• Meningococcal
• Pneumococcal
• Rotavirus
• Varicella (Chickenpox)
• Iron supplements for children ages 6 to 12 months at risk for anemia

• Lead screening for children at risk of exposure
• Maternal depression screening for mothers of infants at 1, 2, 4, and 6-month visits
• Medical history for all children throughout development ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years
• Obesity screening and counseling
• Oral health risk assessment for young children ages: 0 to 11 months, 1 to 4 years, 5 to 10 years
• Phenylketonuria (PKU) screening for newborns
• Sexually transmitted infection (STI) prevention counseling and screening for adolescents at higher risk
• Tuberculin testing for children at higher risk of tuberculosis ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years
• Vision screening for all children

See Also

• Affordable Care Act
• Public health
• Healthcare in the United States

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