Preventive care benefits for children

Most health plans must cover a set of preventive health services for children at no cost. This includes Marketplace and Medicaid coverage.

IMPORTANT These services are free only when delivered by a doctor or other provider in your plan’s network.

Coverage for children’s preventive health services

All Marketplace health plans and many other plans must cover the following list of preventive services for children without charging you a copayment or coinsurance. This is true even if you haven’t met your yearly deductible.

  1. Alcohol, tobacco, and drug use assessments for adolescents
  2. Autism screening for children at 18 and 24 months
  3. Behavioral assessments for children ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years
  4. Bilirubin concentration screening for newborns
  5. Blood pressure screening for children ages: 0 to 11 months, 1 to 4 years , 5 to 10 years, 11 to 14 years, 15 to 17 years
  6. Blood screening for newborns
  7. Cervical dysplasia screening for sexually active females
  8. Depression screening for adolescents beginning routinely at age 12
  9. Developmental screening for children under age 3
  10. Dyslipidemia screening for all children once between 9 and 11 years and once between 17 and 21 years, and for children at higher risk of lipid disorders ages: 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years
  11. Fluoride chemoprevention supplements for children without fluoride in their water source
  12. Fluoride varnish for all infants and children as soon as teeth are present
  13. Gonorrhea preventive medication for the eyes of all newborns
  14. Hearing screening for all newborns; and for children once between 11 and 14 years, once between 15 and 17 years, and once between 18 and 21 years
  15. Height, weight and body mass index (BMI) measurements for children ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years
  16. Hematocrit or hemoglobin screening for all children
  17. Hemoglobinopathies or sickle cell screening for newborns
  18. Hepatitis B screening for adolescents at high risk, including adolescents from countries with 2% or more Hepatitis B prevalence, and U.S.-born adolescents not vaccinated as infants and with at least one parent born in a region with 8% or more Hepatitis B prevalence: 11–17 years
  19. HIV screening for adolescents at higher risk
  20. Hypothyroidism screening for newborns
  21. Immunization vaccines for children from birth to age 18 — doses, recommended ages, and recommended populations vary:

  22. Iron supplements for children ages 6 to 12 months at risk for anemia

  23. Lead screening for children at risk of exposure
  24. Maternal depression screening for mothers of infants at 1, 2, 4, and 6-month visits
  25. Medical history for all children throughout development ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years
  26. Obesity screening and counseling
  27. Oral health risk assessment for young children ages: 0 to 11 months, 1 to 4 years, 5 to 10 years
  28. Phenylketonuria (PKU) screening for newborns
  29. Sexually transmitted infection (STI) prevention counseling and screening for adolescents at higher risk
  30. Tuberculin testing for children at higher risk of tuberculosis ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years
  31. Vision screening for all children

More information about preventive services for children

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