Health plans cover preventive care under January 2025 standards

Covered insurers must pay for the listed vaccines, screenings, and other preventive care without charging patients a share of the cost. The law covers individual, group, and blanket health insurance, with exceptions for the individual and group plan rule. The individual and group plan rule excludes coverage held on March 23, 2010 that keeps its protected status under federal rules. It also excludes accident-only, disease-specific, hospital, indemnity, disability income, and other fixed-payment policies. Covered services must fit the patient and the listed recommendations. They include highly rated preventive services, routine vaccines, and specified preventive care for children and women. Vaccines may qualify under the federal vaccine committee's recommendations or national clinical guidelines or standards of care. Insurers may charge patients for treatment outside the listed services, even when it follows a covered screening. January 1, 2025 is the reference date for the recommendations and guidelines that determine covered care.