Minimum Essential Coverages (MEC) Included in PrimeCARE
Full List of ACA Required Services
- Abdominal Aortic Aneurysm one-time screening for men of specifiedages who have ever smoked
- Alcohol Misuse screening and counseling
- Aspirin use to prevent cardiovascular disease and colorectal cancerfor adults 50 to 59 years with a high cardiovascular risk
- Blood Pressure screening
- Cholesterol screening for adults of certain ages or at higher risk
- Colorectal Cancer screening for adults 45 to 75
- Depression screening
- Diabetes (Type 2) screening for adults 40 to 70 years who are overweight orobese
- Diet counseling for adults at higher risk for chronic disease
- Falls prevention (with exercise or physical therapy and vitamin D use) foradults 65 years and over living in a community setting
- Hepatitis B screening for people at high risk
- Hepatitis C screening for adultsage18 to 79 years
- HIV screening for everyone age 15 to 65, and other ages at increasedrisk
- PrEP(pre-exposure prophylaxis) HIV prevention medication for HIV-negative adults at high risk for getting HIV through sex or injectiondrug use
- Immunizations for adults—doses, recommended ages, andrecommended populations vary: Chickenpox (Varicella), Diphtheria,Flu (influenza), Hepatitis A, Hepatitis B, Human Papillomavirus (HPV),Measles, Meningococcal, Mumps, Whooping Cough (Pertussis),Pneumococcal, Rubella, Shingles, and Tetanus
- Lung cancer screening for adults 55 to 80 at high risk for lung cancerbecause they’re heavy smokers or have quit in the past 15 years
- Obesity screening and counseling
- Sexually Transmitted Infection (STI) prevention counseling for adults athigher risk
- Statin preventive medication for adults 40 to 75 years at high risk
- Syphilis screening for all adults at higher risk
- Tobacco use screening for all adults and cessation interventions for tobaccousers
- Tuberculosis screening for certain adults with symptoms at high risk Preventive BenefitsforWomen
- Bone density screening for all women over age 65 or womenage64 andyounger that have gone through menopause
- Breast cancer genetic test counseling (BRCA) for women at higher
- risk(counseling only; not testing)
- Breast cancer mammography screenings: every 2 years for women over
- 50 and older or as recommended by a provider for women 40 to 49 orwomen at higher risk for breast cancer
- Breast Cancer chemoprevention counseling for women at higher risk
- Breastfeeding comprehensive support and counseling from trainedproviders, and access to breastfeeding supplies, for pregnant and nursingwomen
- Birth control: Food and Drug Administration-approved contraceptivemethods, sterilization procedures, and patient education and counseling, asprescribed by a health care provider for women with reproductive capacity(not including abortifacient drugs). This does not apply to health planssponsored by certain exempt “religious employers.”
- Cervical Cancer screening: Pap test (also called a Pap smear) for women 21to 65
- Chlamydia infection screening for younger women and other women athigher risk
- Diabetes screening for women with a history of gestational diabetes whoaren’t currently pregnant and who haven’t been diagnosed with type 2diabetes before
- •Domestic and interpersonal violence screening and counseling for allur international health insurance plans offer coverage for medical treatment and emergencies worldwide.
- Folic acid supplements for women who may become pregnant
- Gestational diabetes screening for women 24 weeks pregnant (or later)and those at high risk of developing gestational diabetes
- Gonorrhea screening for all women at higher risk
- Hepatitis B screening for pregnant women at their first prenatal visit
- Maternal depression screening for mothers at well-baby visits
- Preeclampsia prevention and screening for pregnant women with high bloodpressure
- Rh Incompatibility screening for all pregnant women and follow-up testingfor women at higher risk
- Sexually Transmitted Infections counseling for sexually active women
- Expanded tobacco intervention and counseling for all pregnant tobaccousers
- Urinary incontinence screening for women yearly
- Urinary tract or other infection screening
- Well-woman visits to get recommended services for women
- Preventive BenefitsforChildren
- Alcohol, tobacco, and drug use assessments for adolescents
- Autism screening for children at 18 and 24 months
- Behavioral assessments for children: Age 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years
- Bilirubin concentration screening for newborns
- Blood Pressure screening for children: Age 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years
- Blood screening for newborns
- Depression screening for adolescents beginning at age 12
- Developmental screening for children under age 3
- Dyslipidemia screening for all children once between 9 and 11 years andonce between 17 and 21 years for children at higher risk of lipid disorders
- Fluoride supplements for children without fluoride in their water source
- Fluoride varnish for all infants and children as soon as teeth are present
- Gonorrhea preventive medication for the eyes of all newborns
- Hearing screening for all newborns; and regular screenings for children andadolescents as recommended by their provider
- Height, weight and body mass index (BMI) measurements takenregularly for all children
- Hematocrit or hemoglobin screening for all children
- Hemoglobinopathies or sickle cell screening for newborns
- Hepatitis B screening for adolescents at higher risk
- HIV screening for adolescents at higher risk
- Hypothyroidism screening for newborns
- PrEP(pre-exposure prophylaxis) HIV prevention medication for HIV-negative adolescents at high risk for getting HIV through sex or injectiondrug use
- Immunizations for children from birth to age 18—doses, recommendedages, and recommended populations vary: Chickenpox (Varicella);Diphtheria, Tetanus, and Pertussis (DTaP);Haemophilusinfluenza typeB; Hepatitis A; Hepatitis B; Human Papillomavirus (HPV); InactivatedPoliovirus; Influenza (flu shot); Measles; Meningococcal; Mumps;Pneumococcal, Rubella; and Rotavirus
- Lead screening for children at risk of exposure
- Obesity screening and counseling
- Oral health risk assessment for young children from 6 months to 6 years
- Phenylketonuria (PKU) screening for newborns
- Sexually Transmitted Infection (STI) prevention counseling and screeningfor adolescents at higher risk
- Tuberculin testing for children at higher risk of tuberculosis: Age 0 to 11months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years
- Vision screening for all children