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What to know about insurance for preventive screenings
What to know about insurance for preventive screenings

Medical News Today

time17-07-2025

  • Health
  • Medical News Today

What to know about insurance for preventive screenings

In the United States, most health insurance plans cover preventive health screenings and services at no cost. However, the services may only be free if a healthcare professional under the plan's network provides and conditions for individual health insurance plans can vary, so people should always check with their insurance provider to see which services are covered and if any fees will article explores which preventive screenings insurance plans cover, whether there are any fees for preventive screenings, and whether Medicare covers use of binary terms such as 'male' and 'female' or 'men' and 'women' in this article reflects the language of the sources we've used. Unless otherwise noted, it's unclear whether the research we reference included participants with expansive gender screenings for all adultsMany health insurance plans will cover the following types of preventive services without charging people a copayment or coinsurance:Preventive screenings for all adults include:blood pressure screeningdepression screeningalcohol misuse screening and counselingobesity screening and counselingcertain vaccinations, depending on a person's age and other factorscholesterol screening, depending on a person's age and other factorstype 2 diabetes screening for anyone between 40 to 70 years of age with overweight or obesitydiet counseling for adults at higher risk for chronic diseasetuberculosis screening for certain people without symptoms who are at high riskaspirin use to prevent cardiovascular disease and colorectal cancer for anyone between 50 to 59 years of age with a high cardiovascular riskstatin preventive medication for certain adults ages 40 to 75 yearscolorectal cancer screening for people between 45 to 75 years of agelung cancer screening for adults ages 50 to 80 at high risk for lung cancer due to current smoking or after quitting smoking in the past 15 yearstobacco use screening for everyone and quitting interventions for people who use tobaccofalls prevention for adults ages 65 years and over who live in a community settinghepatitis B screening for people at high riskhepatitis C screening for people between the ages of 18 to 79 yearssexually transmitted infection (STI) prevention counseling for individuals at higher risksyphilis screening for adults at higher riskHIV screening for anyone ages 15 to 65, and other ages at increased riskpreexposure prophylaxis (PrEP) HIV prevention medication for individuals at high risk of contracting HIV through sex or injection drug useFor menAdditionally, most health insurance plans should cover abdominal aortic aneurysm one-time screening for men of specified ages who have ever smoked without charging them a copayment or screenings for womenMany health insurance plans should also cover the following types of preventive services for women without charging them a copayment or coinsurance:Cervical cancer screening, which includes Pap tests for individuals ages 21 to cancer screening mammogram, with or without clinical breast examination, every 1 to 2 years for individuals ages 40 and cancer chemoprevention counseling for individuals at higher cancer genetic test counseling for those at higher and interpersonal violence screening and counseling. Yearly urinary incontinence screening for people with a history of gestational diabetes who are not currently pregnant and who have not been diagnosed with type 2 screening for younger individuals and those at higher screening for people at higher density screening for individuals over age 65 or 64 years and younger who have experienced healthcare professional visits to get recommended screenings for people who are pregnant or may become pregnantFor people who are pregnant or may become pregnant, many health insurance plans will also cover the following types of preventive services without charging a copayment or coinsurance:birth controlsyphilis screeningurinary tract or other infection screeningfolic acid supplements for individuals who may become pregnanthepatitis B screening for pregnant people at their first prenatal visitgestational diabetes screening for people who are 24 weeks pregnant or later and those at high risk of developing gestational diabetespreeclampsia prevention and screening for pregnant people with high blood pressureRh incompatibility screening for all pregnant people and follow-up testing for individuals at higher riskbreastfeeding support and counseling from trained providers, and access to breastfeeding supplies, for people who are pregnant or nursingpostpartum depression screening for birthing parents at baby doctor visitsexpanded tobacco intervention and counseling for pregnant people who use tobaccoPreventive screenings for childrenMost health insurance plans should also cover the following types of preventive services for children and infants without charging a copayment or coinsurance:blood screening for newbornshearing screening for all newborns, and regular screenings for children and adolescents, as a healthcare professional recommendshemoglobinopathies or sickle cell screening for newbornsbilirubin concentration screening for newbornsphenylketonuria screening for newbornsgonorrhea preventive medication for the eyes of all newbornshypothyroidism screening for newbornsautism screening for children at 18 and 24 monthsoral health risk assessment for young children from ages 6 months to 6 yearsfluoride varnish for all infants and children as soon as teeth are presentfluoride supplements for children without fluoride in their water sourcedevelopmental screening for children under age 3regular height, weight, and body mass index (BMI) measurements for all childrenregular baby and child doctor visitsbehavioral assessments for all childrenvision screening for all childrenhematocrit or hemoglobin screening for all childrendyslipidemia screening for all children once between 9 and 11 years and once between 17 and 21 years, and for children at higher risk of lipid disorderslead screening for children at risk of lead exposuretuberculin testing for children at higher risk of tuberculosisAre there any fees for preventive screenings?Preventive screenings are usually only free of charge if a healthcare professional in the plan's network provides insurance providers may charge a fee if a person receives preventive services from an out-of-network provider. They may also charge a fee for some doctor's office visit costs if preventive service is not the main purpose of the a person's insurance may not cover preventive services if a person has a 'grandfathered' health insurance should always check the terms and conditions for their individual health insurance plan or contact their insurance provider for more without health insurance may still be able to access free or reduced-cost preventive screenings through options like Medicaid, community health centers, or charity clinics. »Learn more:What medical care is available without insurance?Does Medicare cover preventive screenings?Medicare Part B covers many preventive screening tests if a person meets certain criteria. Many of these services are free of charge, but people should always check the terms and conditions of their individual Medicare plan for more information, as plan benefits can example, someone with a Medicare Advantage Plan may have access to certain preventive services that Original Medicare does not cover, and their costs and coverage rules may resourcesFor more resources to help guide you through the complex world of medical insurance, visit our Medicare to speak with a doctorPeople should aim to attend any preventive screenings that are recommended based on their age or other factors, such as pregnancy or tobacco who is unsure about which preventive services would benefit them may want to contact a healthcare professional for further information.»FIND CARE:Find a healthcare professional in your area health insurance plans cover preventive health screenings and services at no extra coverage and fees can differ between plans. For example, insurance providers may charge a fee if a person receives preventive services from an out-of-network provider. A person should always check the terms and conditions of their health insurance plan or contact their provider for more who do not have health insurance may want to explore options such as Medicaid, community health centers, or charity clinics.

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