Individual Wellness

INDIVIDUAL WELLNESS PLANS

FREE Wellness and Preventive Incentives!

A key provision of the Affordable Care Act (ACA) is the requirement that private insurance plans cover recommended preventive services without any patient cost-sharing.1 Research has shown that evidence-based preventive services can save lives and improve health by identifying illnesses earlier, managing them more effectively, and treating them before they develop into more complicated, debilitating conditions, and that some services are also cost-effective.2 However, costs do prevent some individuals from obtaining preventive services (Figure 1). The coverage requirement aims to remove cost barriers.

ACA Requirements for Coverage of Preventive Services

Under Section 2713 of the ACA, private health plans must provide coverage for a range of preventive services and may not impose cost-sharing (such as copayments, deductibles, or co-insurance) on patients receiving these services.3 These requirements apply to all private plans – including individual, small group, large group, and self-insured plans in which employers contract administrative services to a third party payer – with the exception of those plans that maintain “grandfathered” status. In order to have been classified as “grandfathered,” plans must have been in existence prior to March 23, 2010, and cannot make significant changes to their coverage (for example, increasing patient cost-sharing, cutting benefits, or reducing employer contributions). In 2014, 26% of workers covered in employer sponsored plans were still in grandfathered plans,4 and it is expected that over time almost all plans will lose their grandfathered status.

Open Enrollment
Nov 1st through Dec 15th

You will need a qualifying life event in order to trigger a Special Enrollment Period, meaning you will not have to wait to enroll during the Annual Enrollment Period beginning Nov 1st through December 15th. Click here for a detailed explanation of how the SEP works. Please keep in mind you have 30 days to apply for coverage from the date the life event occurred.
  • Loss of health coverage
    • Losing existing health coverage, including job-based, individual, and student plans
    • Losing eligibility for Medicare, Medicaid, or CHIP
    • Turning 26 and losing coverage through a parent’s plan
  • Changes in household
    • Getting married or divorced
    • Having a baby or adopting a child
    • Death in the family
  • Changes in residence
    • Moving to a different ZIP code or county
    • A student moving to or from the place they attend school
    • A seasonal worker moving to or from the place they both live and work
    • Moving to or from a shelter or other transitional housing
  • Other qualifying events
    • Changes in your income that affect the coverage you qualify for
    • Gaining membership in a federally recognized tribe or status as an Alaska Native Claims Settlement Act (ANCSA) Corporation shareholder
    • Becoming a U.S. citizen
    • Leaving incarceration (jail or prison)
    • AmeriCorps members starting or ending their service

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Click The Toggles Below To Learn More About Wellness and Prevention Incentives

Adult Men
This screening checks if you are at risk of an aneurysm (swelling) in your aorta (your body's main artery to the heart). It's important to catch this because the artery may burst. It's available to men aged 65–75 who have ever smoked.
Alcohol misuse refers to drinking habits that are unhealthy but do not meet the medical requirements for alcohol dependency. Screening and counseling may help identify, manage, and treat alcohol misuse. Alcohol misuse is the third leading cause of preventable death in the United States.
Taking low-dose aspirin regularly can lower your risk for heart attack, stroke, and colorectal cancer. Ask your doctor about taking aspirin regularly if you have any of these risk factors for heart disease: smoking, high blood pressure, high cholesterol, or diabetes. This service is available if you're aged 50–59 with a high cardiovascular risk, or if you're a woman aged 12–59 who is pregnant and has high blood pressure.
One in 3 American adults have high blood pressure. High blood pressure increases your risk for serious health problems, including stroke and heart attack. Get your blood pressure checked regularly starting at age 18. This screening is available to both children and adults.
It's important to get your cholesterol checked at least every 4–6 years. Too much cholesterol in your blood can cause a heart attack or a stroke.
If you are age 50–75, get tested regularly for colorectal cancer. A screening can help prevent colorectal cancer or find it early, when it’s easier to treat. You may need to get tested before age 50 or after age 75 if colorectal cancer runs in your family.
Depression is an illness that involves the brain. It can affect your thoughts, mood, and daily activities. Depression is more than feeling sad for a few days. If you think you might be depressed, talk with a doctor about how you are feeling.
Diabetes is a leading cause of disability and death in the United States. Diabetes increases the risk of serious health problems like heart disease, stroke, and kidney disease. This screening is available to adults aged 40-70 who are overweight or obese. It's also available to women with a history of gestational diabetes who aren't currently pregnant.
This counseling will help you follow a healthy eating pattern that includes a variety of nutritious foods and drinks, at the right amount of calories. This service is available to adults at high risk for chronic disease.
This may involve exercise, physical therapy, or vitamin D use. This service is available to adults aged 65 and up who are living in a community setting.
This screening is available to adolescents (age 11 and up) and adults at high risk. Along with pregnant women at their first prenatal visit.
This service is available to adults at higher risk and a one-time screening is available to anyone born between 1945–1965.
This service is available to anyone between 15 to 65 years old, and other ages who have increased risk.
This includes vaccines for:
  • Diphtheria
  • Hepatitis A
  • Hepatitis B
  • Herpes Zoster
  • Human Papillomavirus (HPV)
  • Influenza (flu shot)
  • Measles
  • Meningococcal
  • Mumps
  • Pertussis
  • Pneumococcal
  • Rubella
  • Tetanus
  • Varicella (Chickenpox)
This list applies to adults only. See the children's section for their list of covered immunizations.
This screening is available for those aged 55-80 at high risk for lung cancer because they're heavy smokers or have quit in the past 15 years.
These services are available to children and adults.
This service is available to sexually active women and adults and adolescents at higher risk.
Statins are medicines that reduce the risk of heart attack and stroke by helping to lower cholesterol levels in the blood. This service is available to adults aged 40–75 at higher risk.
Syphilis is a sexually transmitted disease (STD). If you are pregnant and have syphilis, you can pass it your baby. This service is available to adults at higher risk.
Smoking is the most preventable cause of death and disease in the United States. This service helps you quit or decrease tobacco use – either through counseling and/or medication.
Taking low-dose aspirin regularly can lower your risk for heart attack, stroke, and colorectal cancer. Ask your doctor about taking aspirin regularly if you have any of these risk factors for heart disease: smoking, high blood pressure, high cholesterol, or diabetes.

Adult Women
This screening is available to women on a routine basis for pregnant women.
Some women with a higher risk of getting breast cancer can take medication that may help lower their risk. This is called chemo-prevention.
Genetic counseling and genetic testing can help you understand your risk for certain types of cancer that can run in families.
Genetic counseling and genetic testing can help you understand your risk for certain types of cancer that can run in families.
Support and counseling from trained providers, and access to breastfeeding supplies. These services are available to pregnant and nursing women.
FDA-approved contraceptive methods, sterilization procedures, and patient education and counseling are all available to women with reproductive capacity (not including abortifacient drugs). Health plans sponsored by certain exempt “religious employers" may not cover these services.
This screening is available with a Pap smear every 5 years or without a Pap smear every 3 years. This is available to women aged 30–65.
This screening is available to women every 3 years.
Chlamydia is a sexually transmitted diseases. A pregnant woman can pass these STDs to her baby during birth. This screening is available to women at higher risk.
Diabetes is a leading cause of disability and death in the United States. Diabetes increases the risk of serious health problems like heart disease, stroke, and kidney disease. This screening is available to adults aged 40-70 who are overweight or obese. It's also available to women with a history of gestational diabetes who aren't currently pregnant.
While it’s not always easy to spot the warning signs of relationship violence, getting counseling can help you recognize unhealthy relationships and get help before they become violent. These services are available to all women.
Smoking is the most preventable cause of death and disease in the United States. This service helps you quit or decrease tobacco use – either through counseling and/or medication.
Folic acid supplements are available to women who may become pregnant.
Gestational diabetes is a type of diabetes that some women develop during pregnancy. This screening is available to women 24–28 weeks pregnant and those at high risk of developing gestational diabetes
Gonorrhea is sexually transmitted diseases (STDs). A pregnant woman can pass this to her baby during birth. This screening is available to all women at higher risk.
This screening is available to pregnant women at their first prenatal visit.
This service is available to all mothers of infants at 1, 2, 4, and 6-month visits.
A bone density test measures how strong bones are. The test will tell you if you have osteoporosis, or weak bones. This screening is available to women aged 61 and up who are at higher risk.
Preeclampsia is a health problem that some women develop after about 20 weeks of pregnancy. Preeclampsia is usually mild, but it can be dangerous and even deadly for both a pregnant woman and her unborn baby. These services are available to pregnant women with high blood pressure.
This screening is available to all pregnant women along with follow-up testing for women at higher risk.
This screening is available to women annually.
For adults at higher risk and all pregnant women
These screenings are available to all women.
Well-woman visits include a full checkup and physical. These visits focus on preventive care for women specifically. This screening is available to women annually who are under age 65.

Children /Youth
These assessments are available to children age 11 and up.
This screening is available to children between 18 and 24 months. Learn more. here.  
These "well-child" assessments are available to all children and should be done once per year.
This includes tests that check for certain diseases and conditions in newborn babies. This screening is available to newborns.
This includes tests that check for certain diseases and conditions in newborn babies. This screening is available to newborns.
One in 3 American adults have high blood pressure. High blood pressure increases your risk for serious health problems, including stroke and heart attack. Get your blood pressure checked regularly starting at age 18. This screening is available to both children and adults.
This screening is available to sexually active females.
Depression is an illness that involves the brain. It can affect your thoughts, mood, and daily activities. Depression is more than feeling sad for a few days. If you think you might be depressed, talk with a doctor about how you are feeling. This service is available to both children and adults.
This can help watch for signs that your child is learning to talk on schedule. This screening is available to children under 3 years old
This screens for lipid disorders—abnormal levels of cholesterol and/or fats in the blood. This screening is available once to children between the ages of 9-11 and once between the ages of 17-21 years old. Along with children at higher risk of lipid disorders.
While it’s not always easy to spot the warning signs of relationship violence, getting counseling can help you recognize unhealthy relationships and get help before they become violent. These services are available to all women.
Smoking is the most preventable cause of death and disease in the United States. This service helps you quit or decrease tobacco use – either through counseling and/or medication.
These supplements are available to children without fluoride in their water source.
This service is available to all infants and children as soon as their teeth are present.
This medication is available to all newborns.
This screening is available to all newborns, once to children between the ages of 11-14, once between the ages of 15-17, and once between the ages of 18 -21 years old.
This service is available to all children.
This includes vaccines for:
  • Diphtheria
  • Haemophilus influenza type b
  • Hepatitis A
  • Hepatitis B
  • Human Papillomavirus (HPV)
  • Inactivated Poliovirus
  • Influenza (flu shot)
  • Measles
  • Meningococcal
  • Pneumococcal
  • Pertussis (Whooping Cough)
  • Rotavirus
  • Tetanus
  • Varicella (Chickenpox)
This list applies to children only. See the adults's section for their list of covered immunizations.
This service is available to all children.
This service is available to all newborns.
This screening is available to adolescents (age 11 and up) and adults at high risk. Along with pregnant women at their first prenatal visit.
This screening is available to anyone between 15 to 65 years old, and other ages who have increased risk.
This service is available to all newborns.
This includes vaccines for: Diphtheria, Haemophilus influenza type b, Hepatitis A, Hepatitis B, Human Papillomavirus (HPV), Inactivated Poliovirus, Influenza (flu shot), Measles, Meningococcal, Pneumococcal, Pertussis (Whooping Cough), Rotavirus, Tetanus, Varicella (Chickenpox)
These supplements are available to all children ages 6 to 12 months at risk for anemia.
Coming into contact with lead can cause problems with kids learning, behavior, and development. That’s why it’s important to take steps to protect your family.
This service is available to all children.
These services are available to children and adults.
This service is available to children between 0-10 years old.
This service is available to newborns.
This service is available to sexually active women and adults and adolescents at higher risk.
This service is available to children at higher risk of tuberculosis.
It’s important for all children to have their vision checked at least once between ages 3 and 5. Even if children don't show signs of eye problems, they still need their vision checked. Finding and treating eye problems early on can save a child’s sight.

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