When insured patients receive these services in network, they do not have to pay a copayment or coinsurance, even if they haven't met their deductible. This applies to patients with health insurance plans that began on or after Sept. 23, 2010. (A few of the preventive services for women apply only to plans starting on or after Aug. 1, 2012, as noted in the list at the link below). "Grandfathered" health plans are exempt from the requirement to cover these services.
- 15 covered preventive services for adults
- 22 covered preventive services for women, including pregnant women
- 26 covered preventive services for children
Here are links to preventive services guides from the major payers:
- Aetna (PDF)
- Blue Cross and Blue Shield of Texas (PDF)
- Cigna (PDF)
- Humana's manual says: "Humana employs nationally recognized
guidelines, thus reducing of guidelines Providers are encouraged to
follow." See the clinical practice guidelines page and the health and wellness resources page on the Humana website. - UnitedHealthcare (PDF)
Source: Texmed.org
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