What is Preventive Services

Preventive services consist of healthcare services that include check-ups, patient counseling and screenings to prevent illness, disease and other health-related problems. Under the Patient Protection and Affordable Care Act (ACA), the U.S. health reform enacted March 23, 2010, most health plans, including those that can be purchased on the Health Insurance Marketplace, are required to cover a set of preventive services at no cost to the policyholder (meaning that you will not have to pay a copayment or coinsurance or meet your deductible to receive certain preventive services). Covered preventive services for adults, women and children are included in all health insurance plans purchased after Sept. 23, 2010.

BREAKING DOWN Preventive Services

Preventive services are intended to help people remain healthy and to detect any health-related problems early while there is a better chance of recovery. There are many methods for prevention of disease. It is recommended that adults and children aim to visit their doctor for regular check-ups, even if they feel healthy, to perform disease screening, identify risk factors for disease, discuss tips for a healthy and balanced lifestyle, stay up to date with immunizations and boosters, and maintain a good relationship with a healthcare provider. For adults, covered preventive services include:

  • Abdominal aortic aneurysm (“AAA”)
  • Alcohol misuse screening and counseling
  • Aspirin use to prevent cardiovascular disease
  • Blood pressure screening
  • Cholesterol screening
  • Colorectal cancer screening for adults over 50
  • Depression screening
  • Diet counseling
  • HIV screening
  • Immunization vaccines
  • Obesity screening
  • Sexually transmitted infections prevention counseling
  • Syphilis screening
  • Tobacco use screening
  • Type 2 diabetes screening

 Preventive services specifically for women include:

  • Anemia screening
  • BRCA counseling for women at higher risk
  • Breast cancer mammography and chemoprevention counseling
  • Breastfeeding counseling
  • Cervical cancer screening
  • Contraception
  • Domestic and interpersonal violence screening and counseling
  • Certain items and services for pregnant women
  • Gestational diabetes screening
  • Osteoporosis screening
  • Rh incompatibility screening

Preventive services specifically for children include:

  • Autism screening
  • Behavioral assessments
  • Children’s immunization vaccines
  • Congenital hypothyroidism screenings for newborns
  • Depression screening
  • Developmental screening
  • Dyslipidemia screening
  • Fluoride chemoprevention
  • Hearing screening for newborns
  • Height, weight and body mass index measurements
  • Hematocrit or hemoglobin screening
  • Iron supplements
  • Lead screening
  • Vision screening

Levels of Preventive Services

Preventive services take place at the primal, primary, secondary, and tertiary prevention levels. In the 1940s, Hugh R. Leavell and E. Gurney Clark coined the term primary prevention. They worked at the Harvard and Columbia University Schools of Public Health, respectively, and later expanded the levels to include secondary and tertiary prevention. Goldston (1987) notes that these levels might be better described as "prevention, treatment, and rehabilitation", though the terms primary, secondary, and tertiary prevention are still in use today.