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University of Illinois Extension

Preventative Care Benefits and Essential Health Benefits are not the Same

Preventative care and essential health benefits are two terms that you may have heard in relationship to you the Affordable Care Act (ACA). You may at quick glance or without thought think they are referring to the same benefits but they in fact are separate health benefits covered under the ACA.

The ACA ensures all Americans will have 10 essential health benefits:

  1. Ambulatory patient services
  2. Emergency services
  3. Hospitalization
  4. Maternity and newborn care
  5. Mental health and substance abuse services
  6. Prescription drugs
  7. Rehabilitative services and devices
  8. Laboratory services
  9. Prevention and wellness services
  10. Pediatric services, including oral and vision care

Number nine in the essential health benefits is prevention and wellness.

The Preventative Care Benefits for adults include:

  • Screenings for adults at risk:
    • Abdominal Aortic Aneurysm screening
    • Blood Pressure screening
    • Cholesterol screening
    • Colorectal Cancer screening
    • Depression screening
    • Diabetes (Type 2) screening
    • HIV screening (ages 15 to 65)
    • Syphilis screening
  • Screening and counseling for:
    • Alcohol Abuse
    • Obesity
    • Tobacco Use
  • Preventative measures:
    • Aspirin use to prevent cardiovascular disease
    • Immunization vaccines
    • Diet counseling for adults at higher risk for chronic disease
    • Sexually Transmitted Infection (STI) prevention counseling
Some of these benefits are dependent on your risks as based on your age, lifestyle choices, and health conditions. These benefits should be at no cost as long as you access them through a service provider in your healthcare network.

For more information on the Essential Health Benefits:

https://www.healthcare.gov/what-does-marketplace-health-insurance-cover/

For more information on Preventative Care Benefits:

https://www.healthcare.gov/what-are-my-preventive-care-benefits/

Posted by Chelsey Byers Gerstenecker at 8:00 AM | Permalink
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