All individual and group health plans are required by the federal Affordable Care Act to cover preventive services without charging you a copay or coinsurance. This is true even if you haven’t met your deductible.
What you need to know about coverage for preventive services
Washington state offers additional preventive services that some health plans may not cover. While self-insured group health plans don't need to cover these services, they still need to cover the preventive services required under the Affordable Care Act. To find out which services you can get, contact your health plan.
Health plans can't require copays or deductibles for preventive services from in-network pharmacies or providers. If you have a health savings account (HSA) plan, you may need to pay a deductible to get preventive supplies or services that are specific to Washington state. However, this can't be more than the minimum deductible for HSA plans.
Federal organizations may approve new recommendations for preventive services. We try to update these every month. For the latest recommendations, please visit the links below.
See preventive services with no out-of-pocket costs for:
- All adults: United States Preventive Services Task Force
- Women: Health Resources and Services Administration Women’s Preventive Services Guidelines
- Children: Health Resources and Services Administration Bright Futures and the Advisory Committee on Immunization Practices
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Adults' no-cost preventive health benefits
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- Abdominal aortic aneurysm one-time screening for men of certain ages who have ever smoked
- Alcohol misuse screening and counseling
- Anxiety disorders screening
- Blood pressure screening
- Cardiovascular disease prevention behavioral counseling for adults at risk
- Colorectal cancer screening for adults 45 to 75
- Contraceptive (birth control) coverage (Washington state-specific)
- Depression and suicide risk screening
- Diabetes (Type 2) screening for adults 35 to 70 who are overweight or obese
- Diet counseling for adults at higher risk for chronic disease
- Falls prevention (with exercise or physical therapy and vitamin D use) for adults who are 65 or older and live in a community setting
- Hepatitis B screening for people at high risk
- Hepatitis C screening for adults 18 to 79
- HIV screening for everyone 15 to 65, and other ages at higher risk
- HIV postexposure prophylaxis drugs (Washington state-specific)
- Hypertension (high blood pressure) screening
- PrEP (pre-exposure prophylaxis) HIV prevention medication
- Immunizations with varying recommended doses, ages and populations: chickenpox (varicella), diptheria, flu (influenza), hepatitis A, hepatitis B, human papillomavirus (HPV), measles, meningococcal disease, mumps, whooping cough (pertussis), pneumococcal disease, rubella, shingles and tetanus
- Lung cancer screening for adults 50 to 80 at high risk
- Obesity screening and counseling
- Sexually transmitted infection (STI) prevention counseling for adults at high risk
- Statin preventive medication for adults 40 to 75 at high risk of heart disease
- Syphilis infection screening for adults at high risk
- Tobacco use screening
- Tuberculosis screening
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Women's no-cost preventive care benefits
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Services for women who are or may become pregnant
- Abortion (Washington state-specific)
- Alcohol use screening
- Anxiety disorders screening
- Aspirin for women at high risk for preeclampsia
- Asymptomatic bacteriuria (bacteria in urine without symptoms) screening
- Breastfeeding support, counseling, equipment, and supplies
- Birth control (FDA-approved)
- Chlamydia and gonorrhea screening for women at higher risk
- Depression and suicide risk screening
- Folic acid supplements for women who may become pregnant
- Gestational diabetes screening for women who are 24 weeks pregnant
- Healthy weight behavioral counseling for pregnant women
- Hepatitis B screening for pregnant women
- HIV screening
- Hypertensive (high blood pressure) disorders screening
- Rh incompatibility screening
- Syphilis screening
- Tobacco intervention and counseling for pregnant women
Other preventive services for women
- Bone density screening for women over 65, or women under 65 who have gone through menopause
- Breast cancer genetic test counseling (BRCA) for women at higher risk
- Breast cancer screening mammogram, including digital breast exams, for women 40 or older (Washington state-specific)
- Breast cancer chemoprevention counseling for women at higher risk
- Cervical cancer screening
- Chlamydia infection screening for younger women and other women at higher risk
- Diabetes screening for women with a history of gestational diabetes
- Domestic and interpersonal violence screening and counseling
- Gonorrhea screening for women at higher risk
- Urinary incontinence screening for women yearly
- Well-woman visits to get recommended services
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Children's no-cost preventive care benefits
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- Alcohol, tobacco, and drug use assessments for adolescents
- Anxiety screening for children 8 to 18
- Autism screening for children at 18 and 24 months
- Behavioral assessments
- Bilirubin concentration screening for newborns
- Blood pressure screening
- Blood screening for newborns
- Depression screening for adolescents, beginning regularly at age 12
- Developmental screening for children under 3
- Dyslipidemia screening for all children, once between 9 and 11 and once between 17 and 21, and for children at higher risk for lipid disorders
- Fluoride supplements for children without fluoride in their water source
- Fluoride varnish for all infants and children as soon as teeth grow in
- Gonorrhea preventive medication for newborns' eyes
- Hearing screening for newborns, and regular screenings for children and adolescents as recommended by their provider
- Height, weight and body mass index (BMI) measurements taken regularly for all children
- High body mass index screening and counseling
- Hepatitis B screening for adolescents at higher risk
- HIV screening for adolescents at higher risk
- PrEP (pre-exposure prophylaxis) HIV prevention medication for HIV-negative adolescents at high risk for getting HIV through sex or injecting drugs
- Immunizations with varying recommended doses, ages, and populations for children from birth to age 18: chickenpox (varicella), diphtheria, tetanus, pertussis (DTaP), haemophilus influenza type B, hepatitis A, hepatitis B, human papillomavirus (HPV), inactivated poliovirus, influenza (flu), measles, meningococcal disease, mumps, pneumococcal disease, rotavirus, and rubella
- Lead screening for children at risk of exposure
- Oral health risk assessment for children from 6 months to 6 years
- Phenylketonuria (PKU) and other heritable or metabolic disorder screening for newborns (Washington state-specific)
- Sexually transmitted infection (STI) prevention counseling and screening for adolescents at higher risk
- Tuberculin testing for children at higher risk of tuberculosis
- Vision screening for all children
- Well-baby and well-child visits