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Health care for kids: 4 things your health plan must fully cover Posted: February 3rd, 2012

By Barbara Marquand

Ben Franklin's observation that "an ounce of prevention is worth a pound of cure" makes a lot of sense when managing your kids' health care, and today it's easier to put into practice.

Under the Patient Protection and Affordable Care Act, the federal health reform law passed in 2010, most group and individual health insurance plans must cover preventive care 100 percent. That means you pay no copay, deductible or coinsurance. Since the law was passed, federal health officials have specified the types of services that should be considered preventive care.

Here are the prevention services the federal government says new health insurance plans must fully cover for children:

1. Well-baby visits

Health care experts say babies should go to the doctor six times during the first year to make sure they're developing on track and to catch any problems early. Your baby should see the doctor two to three days after coming home from the hospital and then at 1, 2, 4, 6 and 9 months.

2. Well-child visits

Kids grow up quickly in the first few years, so it's important to check in regularly with a doctor. Well-child visits are recommended at 12, 15, 18, 24 and 30 months and then once a year for children ages 3 to 18.

3. Vaccinations

Routine vaccines are fully covered, including tetanus, diphtheria and pertussis; hepatitis A and B; measles, mumps and rubella; varicella (chickenpox); and other standard recommended shots.

4. Screenings

Fully covered screenings include developmental and behavioral assessments, blood pressure screening, and height and weight measurements. Also included are screenings for these conditions:

  • Obesity in children 6 and older. Health education counseling to help your child achieve a healthy weight is also fully covered.
  • Depression among adolescents.
  • Sexually transmitted infection, including HIV, among adolescents at risk.
  • Lead poisoning for children at risk of exposure.
  • Cervical cancer. Pap tests are fully covered for teen girls who have been sexually active for three years.
  • Alcohol and drug use among adolescents.
  • Autism. Screening is covered at 18 months and 24 months.
  • Anemia. Iron supplements are fully covered for children ages 6 months to 12 months at risk for anemia.

The U.S. Department of Health and Human Services provides more detail about preventive services on its HealthCare.gov website, including what you can do to help your child stay healthy.