Determining your plan’s preventive care services
To determine your plan’s preventive care services you need to know whether, or not, you have a grandfathered health plan in respect to the Affordable Care Act (ACA). Grandfathered plans do not need to follow the ACA's requirements for preventive care, but are required to follow other aspects of the Affordable Care Act.
Step 1: Review your contract documents before obtaining services
Your contract documents, including your outline of coverage, explain your plan’s preventive care services and what you may pay.
Step 2: Grandfathered or ACA Preventive Care Services
Step 3: Learn more about your preventive care benefits
Grandfathered preventive care services
- Review your health plan contract, which includes your outline of coverage, for information about your preventive care benefits, including what you may pay for services.
- Your plan may cover group-specific preventive care services. Contact your group benefits administrator or a member of our customer service team to learn more.
ACA preventive care services
- List of preventive care services covered at zero cost-share
Understanding preventive care: list of screening services for adults and children eligible under the ACA. This means, as long as you stay in-network and follow your plan's guidelines, it's likely you will pay nothing for these services.
- Procedure codes for (ACA) preventive services
This may help you and your doctor determine what services are available to you at zero cost.
- Some preventive services may require you to pay. It's important you understand which services require payment from you before you receive them.
Do you have questions?
If you have questions about your plan’s preventive services, please contact your group benefits manager or our customer service team at the number on the back of your ID card. Our customer service team is available Monday through Friday, from 7 a.m. to 6 p.m., except for holidays.