Blog 1/2/2019

Preventive Care Updates for 2019

What’s considered “preventive care” is established by four organizations: the U.S. Preventive Services Task Force (USPSTF), the Advisory Committee on Immunization Practices (ACIP), the Health Resources and Services Administration’s (HRSA’s) Bright Futures Project, and HRSA and the Institute of Medicine (IOM) committee on women’s clinical preventive services.

The list of covered preventive services is updated on an annual basis; health plans and insurers are required to cover any newly added services beginning in the plan year that begins on or after exactly one year from the latest issue date (so if the USPSTF issues a new recommendation in May 2018, it must be covered by January 2020, assuming a calendar-year plan year).

As you know, the ACA requires non-grandfathered plans to cover preventive services without cost sharing (no deductible, copay or coinsurance). The list of covered preventive services is reviewed and updated annually by the U.S. Preventive Services Task Force (USPSTF), the Advisory Committee on Immunization Practices (ACIP), the Health Resources and Services Administration’s (HRSA’s) Bright Futures Project, and HRSA and the Institute of Medicine (IOM) committee on women’s clinical preventive services. Health plans and insurers are required to cover any newly added services beginning in the plan year that begins on or after exactly one year from the latest issue date.

There are updates and new services that must be covered in 2019. These include:

  • Preeclampsia screenings through a blood pressure test
  • Obesity screenings for children and adolescents 6 years and older
  • Vision screening in children ages 3 to 5 to detect amblyopia or its risk factor
  • Skin cancer behavioral counseling for fair-skinned people age 6 months to 24 years
  • Updated Hepatitis B, DTaP, Tdap and Td vaccination recommendations
  • Human papillomavirus (HPV) vaccine for adolescents
  • Depression screening for adolescents beginning at age 12

For a more complete list, as well as links for more information, see here: Preventive Care Updates.

If your SPDs or other communication materials include details on preventive services and/or immunization schedules, you might want to review them against this list and discuss with your carrier(s).

(Kim Buckey, vice president of client services at DirectPath)

 

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