Preventive Care Services Covered at 100% Under Health Care Reform?

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WPS Health Insurance, a Leading Provider of Individual Health Insurance, Explains

WPS is Wisconsin's leading not-for-profit health insurer.

Getting regular preventive care is easily the most important thing Wisconsin residents can do to avoid illness and protect their health.

The Affordable Care Act of 2010 brings sweeping changes to health insurance coverage in the United States, including the requirement that new health plans—both group and individual—pay 100% of the costs of certain preventive care services such as mammograms, colonoscopies, blood pressure checks, and childhood immunizations. WPS Health Insurance, Wisconsin’s leading not-for-profit health insurer and provider of affordable group and individual health insurance, examines this new requirement and details the specific covered services for adults, women, and children in a new educational article, “Stay Healthy, Save Money with Preventive Services Covered at 100% Under Health Care Reform,” available for free from the WPS online Learning Center.

“Getting regular preventive care is the single most important thing Wisconsin residents can do to protect their health,” said Dr. Marvin Wiener, Senior Medical Director at WPS Health Insurance. “Yet today, only about half of all Americans get the preventive care they need. That’s unfortunate when you consider that chronic diseases such as heart disease, cancer, stroke, and diabetes are responsible for 7 of 10 deaths among Americans each year—and they are often preventable.”

Under the Affordable Care Act, all group and individual health plans that take effect on or after September 23, 2010 are required to cover recommended preventive care services without charging a copayment, deductible, or coinsurance, so long as the services are received from an in-network health care provider.

“Doctors and health care facilities continue to charge for these services. But now it’s the health insurance companies that pay the costs,” said Dr. Wiener. “Essentially, preventive care becomes ‘free’ for the policyholder, greatly increasing the incentive to take advantage of these services.”

Depending on the policyholder’s age, covered preventive care services may include:

  • Blood pressure, diabetes, and cholesterol tests
  • Many types of cancer screenings, including mammograms and colonoscopies
  • Routine vaccinations against diseases such as measles, polio, influenza (flu), and meningitis
  • Counseling, screening, and vaccines to ensure healthy pregnancies
  • Regular well-baby and well-child visits from birth to age 21

The full article includes a complete list of preventive care services covered for adults, women, and children, as well as additional details about the new rules.

WPS encourages individuals and families looking for more health insurance tips and strategies to check out the WPS Learning Center for free articles on controlling costs, preventing illness, making wise health decisions, and other timely topics. For questions or to request a quote for a high-quality individual or family plan from WPS, please call 1-888-245-4197 to talk with a friendly representative.

About WPS Health Insurance
Founded in 1946, WPS is Wisconsin’s leading not-for-profit health insurer, offering affordable individual health insurance, family health insurance, high-deductible health plans, and short-term health insurance, as well as flexible and affordable group plans and cost-effective benefit plan administration for businesses. In addition, the WPS Medicare division administers Part A and B benefits for millions of seniors in multiple states, and the WPS TRICARE division serves millions more members of the U.S. military and their families. In 2010 and 2011, WPS was recognized by the international Ethisphere™ Institute as one of the World’s Most Ethical Companies, and is the only health insurance company to earn this distinction. For more information about WPS Health Insurance, visit

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Tami Gilbertson
WPS Health Insurance
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