PRIVACY POLICY

Lower Cost of Being Healthy

Wellness Plans

A key provision of the Affordable Care Act (ACA) is the requirement that private insurance plans cover recommended preventive services without any patient cost-sharing. Research has shown that evidence-based preventive services can save lives and improve health by identifying illnesses earlier, managing them more effectively, and treating them before they develop into more complicated, debilitating conditions.

INDIVIDUAL WELLNESS PLANS

FREE Wellness and Preventive Incentives!

Under Section 2713 of the ACA, private health plans must provide coverage for a range of preventive services and may not impose cost-sharing (such as copayments, deductibles, or co-insurance) on patients receiving these services.3 These requirements apply to all private plans – including individual, small group, large group, and self-insured plans in which employers contract administrative services to a third party payer – with the exception of those plans that maintain “grandfathered” status. In order to have been classified as “grandfathered,” plans must have been in existence prior to March 23, 2010, and cannot make significant changes to their coverage (for example, increasing patient cost-sharing, cutting benefits, or reducing employer contributions). In 2014, 26% of workers covered in employer sponsored plans were still in grandfathered plans,4 and it is expected that over time almost all plans will lose their grandfathered status.

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Open Enrollment
Nov 1st through Dec 15th


What is a Special Enrollment Period?
You will need a qualifying life event in order to trigger a Special Enrollment Period, meaning you will not have to wait to enroll during the Annual Enrollment Period beginning Nov 1st through December 15th. Click here for a detailed explanation of how the SEP works. Please keep in mind you have 30 days to apply for coverage from the date the life event occurred.


Loss of health coverage

  • Losing existing health coverage, including job-based, individual, and student plans
  • Losing eligibility for Medicare, Medicaid, or CHIP
  • Turning 26 and losing coverage through a parent’s plan
Changes in household
  • Getting married or divorced
  • Having a baby or adopting a child
  • Death in the family
  • Changes in residence
  • Moving to a different ZIP code or county
  • A student moving to or from the place they attend school
  • A seasonal worker moving to or from the place they both live and work
  • Moving to or from a shelter or other transitional housing
Other qualifying events
  • Changes in your income that affect the coverage you qualify for
  • Gaining membership in a federally recognized tribe or status as an Alaska Native Claims Settlement Act (ANCSA) Corporation shareholder
  • Becoming a U.S. citizen
  • Leaving incarceration (jail or prison)
  • AmeriCorps members starting or ending their service

qualified health plans must include screenings

Below is a short list of screenings for Adult Men, Adult Women and Children and Youth.

Adult Men

Abdominal Aortic Aneurysm one-time screening

This screening checks if you are at risk of an aneurysm (swelling) in your aorta (your body's main artery to the heart). It's important to catch this because the artery may burst. It's available to men aged 65–75 who have ever smoked

Alcohol misuse screening and counseling

Alcohol misuse refers to drinking habits that are unhealthy but do not meet the medical requirements for alcohol dependency. Screening and counseling may help identify, manage, and treat alcohol misuse. Alcohol misuse is the third leading cause of preventable death in the United States.

Blood pressure screening

One in 3 American adults have high blood pressure. High blood pressure increases your risk for serious health problems, including stroke and heart attack. Get your blood pressure checked regularly starting at age 18. This screening is available to both children and adults.

Cholesterol screening

It's important to get your cholesterol checked at least every 4–6 years. Too much cholesterol in your blood can cause a heart attack or a stroke.

Colo-rectal cancer screening

If you are age 50–75, get tested regularly for colorectal cancer. A screening can help prevent colorectal cancer or find it early, when it’s easier to treat. You may need to get tested before age 50 or after age 75 if colorectal cancer runs in your family.

Diabetes screening

Diabetes is a leading cause of disability and death in the United States. Diabetes increases the risk of serious health problems like heart disease, stroke, and kidney disease. This screening is available to adults aged 40-70 who are overweight or obese. It's also available to women with a history of gestational diabetes who aren't currently pregnant.

Adult Women

Anemia screening

This screening is available to women on a routine basis for pregnant women.

Breast cancer chemo-prevention counseling

Some women with a higher risk of getting breast cancer can take medication that may help lower their risk. This is called chemo-prevention.

Breast cancer genetic test counseling (BRCA)

(BRCA)
Genetic counseling and genetic testing can help you understand your risk for certain types of cancer that can run in families.

Breast cancer mammography screenings

Genetic counseling and genetic testing can help you understand your risk for certain types of cancer that can run in families.

Contraception

FDA-approved contraceptive methods, sterilization procedures, and patient education and counseling are all available to women with reproductive capacity (not including abortifacient drugs). Health plans sponsored by certain exempt “religious employers" may not cover these services.

Diabetes screening

Diabetes is a leading cause of disability and death in the United States. Diabetes increases the risk of serious health problems like heart disease, stroke, and kidney disease. This screening is available to adults aged 40-70 who are overweight or obese. It's also available to women with a history of gestational diabetes who aren't currently pregnant.

Cervical cancer screening (Pap smear)

This screening is available to women every 3 years.

Children /Youth

Autism screening

This screening is available to children between 18 and 24 months. Play video.

LEARN MORE

Behavioral assessments

These "well-child" assessments are available to all children and should be done once per year.

Bilirubin concentration screening

This includes tests that check for certain diseases and conditions in newborn babies. This screening is available to newborns

Blood screenings

This includes tests that check for certain diseases and conditions in newborn babies. This screening is available to newborns.

Blood pressure screening for children

One in 3 American adults have high blood pressure. High blood pressure increases your risk for serious health problems, including stroke and heart attack. Get your blood pressure checked regularly starting at age 18. This screening is available to both children and adults.

Depression screening

Depression is an illness that involves the brain. It can affect your thoughts, mood, and daily activities. Depression is more than feeling sad for a few days. If you think you might be depressed, talk with a doctor about how you are feeling. This service is available to both children and adults.

Cervical cancer screening (Pap smear)

This can help watch for signs that your child is learning to talk on schedule. This screening is available to children under 3 years old