Coverage of Preventive Care Services
Overview
The Affordable Care Act (federal healthcare reform) requires nongrandfathered health plans to provide coverage without imposing any cost-sharing requirements (such as a copayment, coinsurance, or deductible) for specific recommended preventive care services. For more information on recommended preventive care services, please see Question 1 of our FAQ (link below) or view a complete list at Healthcare.gov/center/regulations/prevention/recommendations.html.
Women's Preventive Care Coverage
Under the Affordable Care Act of 2010, many women’s preventive healthcare services are already covered with no cost sharing for new health plans. On August 1, 2011, the Department of Health and Human Services (HHS) adopted additional guidelines for Women’s Preventive Services that will be covered at no cost starting with August 2012 renewals and new policies. Read about the benefits that comply with or exceed these federal requirements in our Women's Preventive Care Coverage document.
Additional Resources
Frequently Asked Questions about the Affordable Care Act as it relates to preventive care
FAQ: Healthcare Reform and Preventive Care
New Member Flier
To help members understand what constitutes preventive care (vs. diagnostic care), and how PacificSource covers these services, we've developed the following educational fliers on September 13, 2011.
Preventive Care: Understanding Your Benefits - Oregon version
Preventive Care: Understanding Your Benefits - Idaho version
Preventive Care Limit Summaries
The following documents (updated September 13, 2011) provide an at-a-glance summary of how various common preventive care services are covered under healthcare reform. Please note these summaries apply only for nongrandfathered plans as they renew on or after September 23, 2010.
Preventive Care Limits for Oregon Plans
Oregon Group Plans - Preferred, Prime, and Choice
Oregon Group Plans - BHP
Oregon Individual Plans
Preventive Care Limits for Idaho Plans
Idaho Group Plans - Preferred
Idaho Group Plans - SmartHealth and Traditional
Idaho Individual Plans - BrightIdea
Idaho Individual Plans - SmartHealth