The Patient Protection and Affordable Care Act (PPACA) and the Health Care and Education Reconciliation Act of 2010 (HCERA) requires coverage of services, medications, and immunizations designated as "preventive care" and are available at no cost-sharing. Medical recommendations for preventive care are continually reviewed and revised, so covered services, medications, or immunizations may change from time to time. Click on the link below for a description of current preventive services.
Some plans may have specific requirements for accessing preventive care. For example, you may be limited to a health care provider in your preferred network, and a written prescription is usually required for the medications to be covered. If your health care provider recommends a service, medication or immunization during a preventive care visit, it isn’t automatically covered at 100% and may be subject to a deductible, copay, or coinsurance.
Check your benefit booklet for details of your plan’s coverage, or call TPSC Member Services at the toll-free number listed on your medical ID card.