New Insurance Rules: Free Preventive Health Care

White House Says Insurance Plans Will Cover Cancer Screening and Other Services Without Co-pays

Medically Reviewed by Laura J. Martin, MD on July 14, 2010
From the WebMD Archives

July 14, 2010 -- A variety of preventive services, from immunizations to colonoscopies, is due to be covered without cost to consumers under new insurance plans as part of the health care reform bill.

The new provisions were announced Wednesday afternoon by first lady Michelle Obama, Jill Biden, wife of Vice President Joe Biden, and Health and Human Services Secretary Kathleen Sebelius.

Under the new rules, if you enroll in a new health plan on or after Sept. 23, 2010, the plan must provide recommended preventive care services without cost-sharing such as co-pays or deductibles.

Details of the provisions were provided at a news teleconference by Nancy-Ann DeParle, White House director of health care reform, and Stephanie Cutter, assistant to the president for special projects.

"Starting on Sept. 23, all new plans have to cover a comprehensive range of preventive services'' recommended by doctors and other experts, without out-of-pocket costs, DeParle said.

Preventive Care: What's Covered?

Depending on the health plan type and such factors as your age, preventive care is expected to include such services as:

  • Blood pressure, diabetes, and cholesterol tests
  • Cancer screenings
  • Counseling on smoking cessation, weight loss, healthy eating, depression treatments, and reduction of alcohol use
  • Vaccines for measles, polio, meningitis, and HPV (human papilloma virus)
  • Shots for flu and pneumonia prevention
  • Screening, vaccines, and counseling for healthy pregnancies
  • Well-baby and well-child visits up to the age of 21, as well as vision and hearing, developmental assessments, and body mass index (BMI) screenings for obesity
  • Mammograms for women over age 40
  • Pap smears for cervical cancer prevention
  • Colon cancer screening tests for adults over age 50


Preventive Care: The Impact

The new regulations represent a fundamental shift in how health care is addressed, DeParle says. "We are shifting form health care coverage meaning coverage for the sick to meaning coverage to keep you well."

The aim, she says, is "to create a healthier country."

''Chronic disease such as heart disease, cancer, diabetes and others are responsible for seven of 10 deaths among American each year and account for 75% of the nation's health care spending," Cutter says.

The co-pays and other out-of-pocket costs to help prevent these problems are a stumbling block, Cutter and DeParle say.  For instance, Cutter says, "12% of children have not had a doctor's visit within the last year and receive recommended care less than half the time."

Over time, between today and 2013, the new preventive care provisions will help an estimated 88 million Americans get preventive care, including those in group and individual plans, according to government estimates. Under many large employer plans, these services have been covered for some time.

Preventive Care: Consumer Advice

What to do next? ''Individuals should check with their employers and their insurance policy about what is covered under those plans," Cutter says. "When the plans turn over to a new one,'' says Cutter, the new covered preventive services provisions will take effect.

Meanwhile, consumers can check out, type in a health plan, and see if preventive care is covered.

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Nancy-Ann DeParle, White House director of health care reform.

Stephanie Cutter, assistant to the president for special projects.

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