Preventive Care and Prescriptions Under The Affordable Care Act

addiction-71574_1280A major component of the Affordable Care Act is guaranteed preventive care services at no cost to any person with healthcare insurance.  At first glance it would appear that free preventive care would include annual wellness exams from the subscriber’s primary care physician along with other yearly checkups at no cost to the subscriber.  However further review of this mandate makes it clear that it has a much broader intention.

The Affordable Care Act requires that certain categories of drugs and other products be included in preventive care services based on recommendations from the U.S. Preventive Services Task Force as well as the Institute of Medicine.  While these recommendations are meant to help prevent disease they also leave room for abuse by subscribers.  Items such as nicotine gum, nicotine lozenges, and nicotine patches can all be acquired at no cost and with no limit in quantity with a prescription from a physician.  With uncontrolled access to such items, abuse is a major concern because it will lead to an increase in long term overall healthcare costs which will result in higher healthcare rates for employers.

Listed below are the types of prescription medications and products that are covered under preventive services and are available to healthcare subscribers at no cost.  This list will be reviewed and periodically updated to reflect medical advances by the U.S. Preventive Task Force and the Institute of Medicine.  Many of these medications and products are only available to subscribers in specific age ranges.

  • Aspirin products – men 45-79, women 55-79
  • Contraception medication and products
  • Vitamin D supplements – adults over 65
  • Folic Acid supplements – women only
  • Breast Cancer prevention – women only
  • Pediatric multivitamins – all children 6 months to 6 years old
  • Smoking cessation products
  • Pediatric iron and fluoride – all children 6-12 months

In order for the preventive medications listed above to be covered at no cost, the subscriber is required to have a prescription form their healthcare provider. Subscribers are encouraged to talk with their healthcare provider about choosing the medications that are right for them.

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