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Coverage Codes for Affordable Care Act (ACA)

 

To help you determine health plan benefits for preventive health services for your patients, we have compiled a list of plan coverage codes that have implemented Affordable Care Act (ACA) requirements. The requirements extend full coverage for well-child visits through age 21 and all U.S. Preventive Services Task Force grade A and B recommended screenings.

 

Some codes have been highlighted; although ACA requirements were incorporated into these plans, many ACA requirements do not apply to them due to the plans' eligibility requirements. For these codes and codes that do not appear on the list, visit HHIN to check for the availability of benefits and applicable coverage levels.

 

 

List of Coverage Codes

 

Skip to: PPO HMO Inactive Footnotes

 

PPO Plans

006#

019

087

333#

334#

340

348*

357*

359

392

 

445*

453

458

475

491

492#

493#

 

536

556

558*

559*

562

574

575

577

579

593

597*

 

 

607

613*

614*

615*

629

632

633*

634*

635#

638

639#

646

648

650*

661#

669*

670#

672*

673*

674*

676*

681

682*

683*

684*

685*

686*

687*

688

689

690

693

711*

712

713

714

715

716

717

718*

719*

722

723

724

726*

727

728

729

730

731

733

734

735

736##

737

738

739

740

742*

743

745

746

747

748

749##

750

751

752

753

754

755

756##

757

758

759

760*

761*

762

763*

764*

765

766##

767*

768

770##

773

775

776

777

778*

779*

780

781

782

786

788

789

790

791

792

793*

794

795

796

797

800#

801#

802#

804

805

806

807

808#

809

810

811

812

813

817

818

819

820

821

822

823

824

825

826

827

828

829

830

831

832*

833

834

835

836

837

838

839

840

842

843##

844

845

846

847

848

849

851

852

853

854##

855

856

857

858

859

860

861

862

863

864

865

866

867

869

870

872

873

875

876

877

878

880

881

882

883

884

885

886

887

888

889

890

891

892

893

894

895

896

898

899

933

934

935

936

937

938

939

940

941

942

943

944

945

946

947

948

949

950

951

952

953

954

959

960

961

962

963

964

965

966

967

977

978

986

987

988

989

990

 

HMO Plans

A-A

A-N#

A-O#

B-A#

B-G#

B-K#

B-N#

B-X#

C-O#

 

E-A*

E-C##

E-D*

E-E

E-F

E-P

E-Q

E-R

E-S*

E-T*

E-U##

E-V

E-W##

E-X*

E-Y

E-Z

 

 

H-W

 

I-A

I-B

I-C

I-D

I-E

I-F

I-G

I-H

I-I

I-J

I-K

I-L

I-M

I-N

I-O

I-P

I-Q

I-R

I-S

I-T

I-U

I-V

I-W

I-X

I-Y

I-Z

J-G#

 

K-A*

K-B

K-C

K-D

K-E

K-F *

N-I

O-A

O-B

O-C

O-D

 

Q-A

Q-B

Q-N

Q-O

Q-P

 

R-A

X-A

X-B

X-C

X-D

X-E

X-F

X-G

X-H#

X-J

X-K#

X-L

X-M

X-Q

X-P*

X-R

X-S

X-U

X-V

X-W

X-Y*

X-Z

 

Y-B

Y-C

Y-D

Y-F

Y-H

Y-L

Y-O

Y-P

Y-Q*

Y-R

Y-T*

Y-V

Y-W

Y-Y

Z-B

Z-C

Z-D

Z-E

Z-F

Z-H#

Z-J

Z-K#

Z-L

Z-M##

Z-N

Z-O

Z-P

Z-Q

Z-R

Z-U

Z-V

Z-W

Z-X

Z-Y

 

Inactive Plans

PPO

392

433

621

637

644

692

 

PPO

799

814

815

816

841

879

 

PPO

955

956

957

958

975

979

980

HMO

X-N

Y-E#

 

Footnotes

Symbol Footnote
* Plans that do not have the 2014 ACA benefits.
# Transitional ACA plans that do not have the 2014 ACA benefits.
## Transitional ACA plans that have the 2014 ACA benefits

 

 

To review the previous version of this policy, refer to Coverage Codes for Affordable Care Act (ACA) - OBSOLETE2.

First Published:04/18/2018
Latest Revision:04/11/2019
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