Preventive Care Services – Commercial and Individual Exchange Medical Policyopen_in_new

UnitedHealthcare covers USPSTF A/B preventive services, ACIP-recommended immunizations and HRSA-required women's services (age‑ and interval‑specific screenings, routine vaccines, counseling, contraception/sterilization, breastfeeding support and one personal electric breast pump E0603 per birth), but excludes diagnostic/surveillance/therapeutic care, travel/school/employment-required exams, investigational services, many breast‑pump accessories and non‑routine vaccines, and benefits may differ for grandfathered or out‑of‑network care. Key requirements: services must be performed by network providers (non‑grandfathered plans to waive cost‑sharing), be billed with the specified preventive ICD‑10 screening codes (often in the primary position), follow age/code/interval limits and billing rules, and certain items (e.g., BRCA testing, CT colonography, some imaging) require prior authorization or plan‑specific coverage.

"Coverage of evidence-based items or services rated 'A' or 'B' by the US Preventive Services Task Force (USPSTF) when provided by network providers (per PPACA). Immunizations for routine use in chil..."