Preventive services for adults
Find out more about preventive care on KP.ORG
- Abdominal aortic aneurysm screening (one time for men 65 to 75 who have ever smoked)
- Age-appropriate preventive medical examinations
- Annual lung cancer screening with low-dose computed tomography, and counseling, in adults 55 to 80 who are at high risk based on their current or past smoking history
- Blood pressure screening
- Cholesterol screening, if at higher risk of cardiovascular disease
- Colon cancer screening (for adults 50 to 75)
- Bowel preparation medications prescribed prior to a screening colonoscopy (will be covered for plan years or policy years beginning on or after January 1, 2017)
- Pre-consultation visit associated with colon cancer screening
- Pathology exam on a polyp biopsy, performed in connection with colon cancer screening
- Depression screening Diabetes screening (type 2) for adults with abnormal blood glucose
- Discussions with primary care physician about:
- Alcohol misuse screening and counseling
- Low-dose aspirin use, if at high risk of cardiovascular disease or colorectal cancer
- Diet, if at higher risk for chronic disease
- Obesity and weight management, including intensive behavioral counseling for overweight adults at risk for cardiovascular disease
- Sexually transmitted infections prevention
- Tobacco use cessation and counseling
- FDA-approved medications for tobacco cessation, including over the-counter medications, when prescribed by a plan provider
- Hepatitis B screening (for adults at higher risk)
- Hepatitis C screening (for adults born between 1945 and 1965)
- Immunizations (doses, recommended ages, and recommended populations vary):
- Hepatitis A
- Hepatitis B
- Herpes zoster
- Human papillomavirus
- Influenza
- Measles, mumps, rubella
- Meningococcal (meningitis)
- Pneumococcal
- Tetanus, diphtheria, pertussis
- Varicella
- Over-the-counter drugs when prescribed by your doctor for preventive purposes:
- Low-dose aspirin to reduce the risk of heart attack
- Low-dose aspirin to prevent colorectal cancer (will be covered for plan years or policy years beginning on or after May 1, 2017)
- Vitamin D supplementation to prevent falls in community-dwelling adults 65 years or older who are at increased risk for falls
- Physical therapy to prevent falls (in community-dwelling adults 65 and older who are at increased risk of falling)
- Routine physical exam
- Sexually transmitted infection screenings (for adults at higher risk)
- Chlamydia
- Gonorrhea
- HIV
- Syphilis
Additional preventive services for women
Find out more about preventive care on KP.ORG
- Anemia screening (for pregnant women)
- BRCA genetic counseling to assess risk of carrying breast/ovarian cancer genes (for those who meet U.S. Preventive Services Task Force guidelines)
- BRCA genetic testing (for high-risk women and when services are ordered by a plan physician)
- Breastfeeding equipment
- Cancer screening:
- Breast cancer (mammography for women 40 and older)
- Cervical cancer (for women 21 to 65)
- Contraceptive devices and drugs (FDA-approved and prescribed by your doctor), contraceptive device removal, and female sterilizations
- Discussions with primary care physician about:
- Breastfeeding and comprehensive lactation support
- Chemoprevention for breast cancer (if at higher risk)
- Contraceptive methods
- Family history of breast and/or ovarian cancer
- Folic acid supplements (if you may become pregnant)
- Interpersonal and domestic violence
- Preconception care
- Tobacco use cessation and counseling for pregnant women
- FDA-approved medications for tobacco cessation for pregnant women, including over-the-counter medications, when prescribed by a plan provider
- Gestational diabetes screening (for pregnant women at high risk, or women 24 and 28 weeks pregnant)
- Hepatitis B screening (for pregnant women at their first prenatal visit)
- HIV screening for pregnant women
- Low-dose aspirin (after 12 weeks of gestation in women who are at high risk for preeclampsia)
- Osteoporosis screening (for women 65 or older, and those at higher risk)
- Over-the-counter folic acid for women to reduce the risk of birth defects when prescribed by your doctor for preventive purposes
- Prescribed, FDA-approved medications for breast cancer prevention (if at higher risk, 35 and older with no prior history of breast cancer)
- Rh incompatibility screening (for pregnant women) and follow-up testing (for those at higher risk)
- Routine physical exam
- Routine prenatal care visits
- Syphilis screening for pregnant women
- Urinary tract or other infection screening (for pregnant women)
Preventive services for children
Find out more about preventive care on KP.ORG
- Age-appropriate preventive medical examinations
- Autism screening by primary care physician (at 18 months and 24 months)
- Behavioral assessments by primary care physician (throughout development)
- Blood pressure screening for adolescents
- Cervical dysplasia screening (for sexually active females)
- Congenital hypothyroidism screening (newborns)
- Depression screening (for adolescents 12 to 18 years)
- Developmental screening (under 3 years) and surveillance (throughout childhood) by primary care physician
- Discussions with primary care physician about:
- Alcohol and drug use counseling for adolescents
- Fluoride supplements for children who have no fluoride in their water source
- Iron supplements for children 6 months to 12 months at risk for anemia
- Obesity screening and counseling
- Sexually transmitted infection prevention counseling for adolescents at higher risk
- Skin cancer counseling for children, adolescents, and young adults aged 10 to 24 years with fair skin in order to minimize exposure to ultraviolet radiation
- Tobacco use cessation and counseling
- Dyslipidemia screening (for children at higher risk of lipid disorders)
- FDA-approved medications for tobacco cessation, including over the-counter medications, when prescribed by a plan provider
- Gonorrhea prevention medication for the eyes (newborns)
- Hearing screening (newborns)
- Height, weight, and body mass index (BMI) measurements (throughout development)
- Hematocrit or hemoglobin screening
- Hemoglobinopathies or sickle cell screening (newborns)
- Hepatitis B screening (for adolescents at higher risk)
- HIV screening (for adolescents at higher risk)
- Immunizations (from birth to 18 years; doses, recommended ages, and recommended populations vary):
- Diphtheria, tetanus, pertussis
- Haemophilus influenzae type B
- Hepatitis A
- Hepatitis B
- Human papillomavirus
- Inactivated poliovirus
- Influenza
- Measles, mumps, rubella
- Meningococcal (meningitis)
- Pneumococcal
- Rotavirus
- Varicella
- Lead screening (for children at risk of exposure)
- Medical history (throughout development)
- Oral health risk assessments by primary care physician
- Fluoride supplementation starting at age 6 months for children who have no fluoride in their water source
- Fluoride varnish for the primary teeth of all infants and children starting at the age of primary tooth eruption
- Over-the-counter drugs when prescribed by your doctor for preventive purposes:
- Iron supplements for children to reduce the risk of anemia
- Oral fluoride for children to reduce the risk of tooth decay
- Phenylketonuria screening (newborns)
- Routine physical exam Tuberculin testing (for children at higher risk of tuberculosis)
- Vision screening