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Free Preventive Services: Take Advantage! (Part 1: Kids)

By Martine G. Brousse (not AI!)

"The Medical Bill Whisperer"

Patient Advocate, Certified Mediator



July 9, 2024


Since 2010 and the Affordable Care Act, insurance companies must cover a number of services at no cost to you and your family. These are “preventive” services with a main objective to shift the current state of our healthcare system from curative and reactive to preventive, and saving lives, money and resources. So, are you taking full advantage?


A. Basics

  1. Does your plan qualify?

  • If you bought your policy yourself through the ACA or Obamacare exchange, or through an insurance agent, it should qualify.

  • If your employer bought the policy through an agent or on the open market, it should qualify

  • If your employer’s plan is ERISA, or self-funded - meaning they are a larger company that determines the terms of their own policy and pay their own claims while the insurance only acts as administrator - it is not required to follow those guidelines but it likely does too.

  • Government-issued policies such as Medicare, Medicaid and Tricare have their own set of rules, and are not specifically included here.

  • Last: do you qualify? Are you a child, or some form of an adult ? If yes, you qualify !!!


B. What it means for your wallet

Your insurance plan must cover a range of medical services without charging members a deductible, copayment or coinsurance, even if they have not yet been met.


Services can include:

  • Documenting your health habits and history

  • Assessing your health status

  • Services that improve your health by preventing diseases and other health problems

  • Screening tests to detect diseases early when they may be easier to treat

  • Education and counseling to help you make informed health decisions

  • Physical exams, tests, scans

  • Setting health goals

  • Advice and support on dealing with an issue or condition

2. Older Children - tweens

  • in addition to above:

  • Well-child visits

  • Lead exposure screenings

  • Obesity screenings

  • Autism screenings and behavioral assessments

3. Teenagers:

  • in addition to above:

  • Screening for certain diseases include STDs, HIV, hepatitis

  • Evaluation for signs of depression, anxiety or unusual mood changes

  • Assessment of risks of alcohol, tobacco, drug use, and obesity

  • Sexual health counseling

C. Caution

  1. These services are free ONLY when delivered by a provider in your plan's network

many "free" stamps

You can locate one by calling your insurance, or visiting their website

2. Remind the staff  this is a preventive visit  or service when making an appointment and at the time of the visit/service. The staff must code as "preventive care" in order for services to be free to you.

3. Some State laws provide adolescents the right to obtain mental health assessments and/or treatment without parental consent, and to deny their parent access to such information or medical records without having given formal consent to the insurance and medical providers.

D. Save money ... and your child's health!

  • Screening tests and checkups can find health problems early, when they may be easier (and cheaper!) to treat. 

  • Preventive services can keep new health problems from developing. This includes vaccines or screenings for certain cancers, like cervical cancer.

  • Finding and treating health problems early can help you avoid costly medical bills down the road. 

  • Get peace of mind. Regular checkups are a chance to share concerns and ask questions about your health — and to get support and guidance from a doctor or health care professional

  • Visit those sites more detailed lists of covered services. Your insurance website and/or policy Human resources and services administration



Martine Brousse was a long-time Billing Manager for Physicians before switching to the side of patients in 2013. The move has allowed her to apply her deep expertise and vast experience of the intricacies of resolving all types of medical bill and claim payment issues in ways that directly and positively impact her clientsʻ finances.


(424) 999 4705 - F (424) 226 1330

@martine brousse 2024 @ the medical bill whisperer 2024 @themedicalbillwhisperer 2024

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