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Preventive Care is
important to your
children’s health

Health Benefits & Coverage

Preventive Care Services for Children

The cost of many screenings and checkups is covered at 100% with no out of pocket costs for you and those on your plan. Take advantage of preventive care and stop problems before they get serious.

To be covered with no out-of-pocket costs, the service must be:

  • Provided by an in-network doctor or facility (urgent care facility, outpatient clinic or ambulatory surgery center)
  • Filed by your doctor as a preventive care visit
  • Identified as preventive care under the Affordable Care Act (ACA)

100% Covered Services for Children

The age and frequency listed below are general recommendations.
Talk to your doctor to find out which of these your children should have based on their health.

Click on each item to see any limits or exclusions.

Infants

Children

Adolescents and Teens

Immunizations

Infants and Children

The following are the recommended vaccines for children that are covered with no out of pocket cost. Doses, recommended ages and recommended populations vary.

See your doctor and refer to the CDC’s posted schedule of immunizations.

  • Diphtheria, Tetanus-Acellular, Pertussis (DTap)
  • Haemophilus Infuenzae Type B (Hib)
  • Hepatitis A
  • Hepatitis B
  • Inactivated Poliovirus (IPV)
  • Influenza (Flu)
  • Measles, Mumps, Rubella (MMR)
  • Pneumococcal
  • Rotavirus
  • Varicella (Chicken Pox)

Adolescents and Teens

  • Human papillomavirus (HPV)
  • Influenza (flu)
  • Meningococcal
  • Tetanus, diphtheria, acellular pertussis (Tdap)

The Affordable Care Act (ACA) has identified certain services as preventive care to be paid at 100%.

  • These benefits are available for members of non-grandfathered individual health insurance plans.
  • If you get benefits from your employer, you may also have these benefits. If your Summary of Benefits section of your Benefit Booklet contains PREVENTIVE CARE covered under federal law, then you have these benefits at no charge IN-NETWORK.
  • These benefits are currently in effect unless otherwise noted.
  • Check your Benefit Booklet for details on other preventive care benefits.
  • This information is a reference tool and does not guarantee payment of any claims.

Still have questions?

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