Preventive Care Benefits for Children

Per Healthcare.gov most health plans must cover a set of preventive health services for children at no cost. This includes Marketplace and Medicaid coverage.

IMPORTANT These services are free only when delivered by a doctor or other provider in your plan’s network.

Coverage for children’s preventive health services

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.

  1. Alcohol and drug use assessments for adolescents
  2. Autism screening for children at 18 and 24 months
  3. 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
  4. 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
  5. Cervical dysplasia screening for sexually active females
  6. Depression screening for adolescents
  7. Developmental screening for children under age 3
  8. Dyslipidemia screening 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
  9. Fluoride chemoprevention supplements for children without fluoride in their water source
  10. Gonorrhea preventive medication for the eyes of all newborns
  11. Hearing screening for all newborns
  12. 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
  13. Hematocrit or hemoglobin screening for all children
  14. Hemoglobinopathies or sickle cell screening for newborns
  15. Hepatitis B screening 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.
  16. HIV screening for adolescents at higher risk
  17. Hypothyroidism screening for newborns
  1. Immunization vaccines for children from birth to age 18 — doses, recommended ages, and recommended populations vary:
  1. Iron supplements for children ages 6 to 12 months at risk for anemia
  1. Lead screening for children at risk of exposure
  2. 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
  3. Obesity screening and counseling
  4. Oral health risk assessment for young children ages: 0 to 11 months, 1 to 4 years, 5 to 10 years
  5. Phenylketonuria (PKU) screening for newborns
  6. Sexually transmitted infection (STI) prevention counseling and screening for adolescents at higher risk
  7. 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
  8. Vision screening for all children