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MEC Covered Services

Updated over 3 weeks ago

Commonly covered services:

  • Annual wellness visits and well-woman exams

  • Blood pressure, cholesterol, and diabetes screenings

  • Mammograms and cervical cancer screenings (Pap tests)

  • Colorectal cancer screening (adults 45-75)

  • Depression and mental health screenings

  • Immunizations and vaccines (flu, HPV, hepatitis, shingles, and more)

  • Contraceptive counseling and FDA-approved birth control methods

  • Pregnancy-related preventive care (gestational diabetes screening, preeclampsia screening, breastfeeding support)

  • Well-child and well-baby visits

  • Vision, hearing, and developmental screenings for children

  • Routine childhood immunizations

  • Obesity screening and counseling

  • Tobacco use screening and cessation support

This is not a complete list. See the detailed breakdowns below for adults, women, and children, or view the Preventive Care Benefits Guide and healthcare.gov/coverage/preventive-care-benefits.

If you're unsure whether a specific service qualifies, contact your provider's office before your visit and confirm the visit will be coded as preventive.


Covered Preventive Services

Adults

  • Alcohol misuse screening and counseling

  • Abdominal aortic aneurysm one-time screening for men of specified ages who have ever smoked

  • Aspirin use to prevent cardiovascular disease and colorectal cancer (adults 50-59 with high cardiovascular risk)

  • Blood pressure screening

  • Cholesterol screening for adults of certain ages or at higher risk

  • Colorectal cancer screening (adults 45-75)

  • Depression screening

  • Diabetes (Type 2) screening (adults 40-70 who are overweight or obese)

  • Diet counseling for adults at higher risk for chronic disease

  • Falls prevention for adults 65+ living in a community setting (exercise, physical therapy, vitamin D)

  • Hepatitis B screening for people at high risk

  • Hepatitis C screening (adults 18-79)

  • HIV screening (ages 15-65, and other ages at increased risk)

  • PrEP (pre-exposure prophylaxis) for HIV-negative adults at high risk

  • Immunizations: Chickenpox, Diphtheria, Flu, Hepatitis A, Hepatitis B, HPV, Measles, Meningococcal, Mumps, Whooping Cough, Pneumococcal, Rubella, Shingles, Tetanus

  • Lung cancer screening (adults 50-80 at high risk)

  • Obesity screening and counseling

  • STI prevention counseling for adults at higher risk

  • Statin preventive medication (adults 40-75 at high risk)

  • Syphilis screening for adults at higher risk

  • Tobacco use screening and cessation interventions

  • Tuberculosis screening for certain adults at high risk

Women

Women have access to additional specialized preventive services tailored to their unique health needs.

  • Bone density screening - All women over 65; women 64 and younger who have gone through menopause

  • Breast cancer genetic test counseling (BRCA) - Women at higher risk (counseling only, not testing)

  • Breast cancer mammography screenings - Every 2 years for women 50+; as recommended for women 40-49 or at higher risk

  • Breast cancer chemoprevention counseling - Women at higher risk

  • Breastfeeding support - Comprehensive support, counseling, and access to breastfeeding supplies

  • Birth control - FDA-approved contraceptive methods, sterilization procedures, and patient education. Does not apply to plans sponsored by certain exempt "religious employers."

  • Cervical cancer screening - Pap test for women 21-65

  • Chlamydia infection screening - Younger women and women at higher risk

  • Diabetes screening - Women with a history of gestational diabetes not currently pregnant or diagnosed with Type 2

  • Domestic and interpersonal violence screening and counseling - All women

  • Folic acid supplements - Women who may become pregnant

  • Gestational diabetes screening - Women 24+ weeks pregnant or at high risk

  • Gonorrhea screening - Women at higher risk

  • Hepatitis B screening - Pregnant women at first prenatal visit

  • Maternal depression screening - Mothers at well-baby visits

  • Preeclampsia prevention and screening - Pregnant women with high blood pressure

  • Rh incompatibility screening - All pregnant women; follow-up testing for women at higher risk

  • STI counseling - Sexually active women

  • Tobacco intervention and counseling - All pregnant tobacco users

  • Urinary incontinence screening - Women yearly

  • Urinary tract or other infection screening

  • Well-woman visits - Recommended services for women

Children

Children have access to age-appropriate preventive services from birth through age 18.

  • Alcohol, tobacco, and drug use assessments for adolescents

  • Autism screening at 18 and 24 months

  • Behavioral assessments (ages 0-17, by age group)

  • Bilirubin concentration screening for newborns

  • Blood pressure screening (ages 0-17, by age group)

  • Blood screening for newborns

  • Depression screening for adolescents beginning at age 12

  • Developmental screening for children under age 3

  • Dyslipidemia screening (once between 9-11 years; once between 17-21 years for higher-risk children)

  • 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; regular screenings as recommended

  • Height, weight, and BMI measurements taken regularly

  • Hematocrit or hemoglobin screening

  • 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) for HIV-negative adolescents at high risk

  • Immunizations (birth to 18): Chickenpox, DTaP, Haemophilus influenza type B, Hepatitis A, Hepatitis B, HPV, Inactivated Poliovirus, Influenza, Measles, Meningococcal, Mumps, Pneumococcal, Rubella, Rotavirus

  • Lead screening for children at risk of exposure

  • Obesity screening and counseling

  • Oral health risk assessment (6 months to 6 years)

  • Phenylketonuria (PKU) screening for newborns

  • STI prevention counseling and screening for adolescents at higher risk

  • Tuberculin testing for children at higher risk (ages 0-17, by age group)

  • Vision screening for all children

  • Well-baby and well-child visits

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