Project for Mind Your Screens and Cues

How the New Health Care Law Impacts Preventive Benefits

The new health care law includes new prevention and wellness benefits that could help keep you healthy and catch health problems early. Under the new law, insurers must offer proven preventive services like screenings, vaccines and checkups to you at no additional out-of-pocket charge.

For People with Insurance:

The health care law requires some new health plans to cover important preventive and wellness benefits with no deductibles and copayments. Examples include services such as screenings and vaccines for cancer or influenza. This requirement applies to new individual and group insurance plans and is effective this year.

For People with Medicare:

Medicare will pay for an annual wellness visit and a personalized prevention plan.

The personalized prevention plan may include the following:

  • An assessment of your health risks
  • Your updated medical history
  • A list of your current health care providers
  • A list of your current prescription medications
  • Your height, weight and blood pressure measurements
  • A screening schedule for appropriate preventive services for you to follow over the next five to 10 years
  • A list of your health risk factors along with treatment options

Medicare will also continue to cover a Welcome to Medicare physical exam for people who are new to the Medicare program. The Welcome to Medicare exam is free, with no deductibles and copayments. Those who are new to Medicare cannot get both the Welcome to Medicare exam and the annual wellness visit during their first 12 months of enrollment. The Welcome to Medicare exam is available during the first 12 months of enrollment into the Medicare program. The annual wellness visit takes place each year after that.

For those with a Medicare Advantage plan, most of these plans offer Medicare-covered preventive services with no deductibles and copayments. The new health care law does not require Medicare Advantage plans to offer preventive services free of charge. If you have a Medicare Advantage plan, check to confirm what, if any,deductibles and copayments there are for preventive services.