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Preventive Benefit Updates for January 1, 2024

December 7, 2023

New state and federal healthcare rules take effect on January 1, 2024. Here’s a roundup of the key changes impacting preventive care benefits:

CDC recommendations

The US Centers for Disease Control and Prevention (CDC) approved two mRNA vaccines for COVID-19, from Pfizer and Moderna, for those 6 months and older. The updated Novavax vaccine was recently approved for those ages 12 and up. Under the terms of the Affordable Care Act, Premera members and all people with commercial health insurance plans through the government or their employer can receive vaccines at no cost.

The CDC also approved a Respiratory Syncytial Virus (RSV) vaccine. In line with their recommendation, RSV vaccinations will be covered in full for Premera members who are adults ages 60 and older, pregnant women, infants younger than 8 months, and infants 8 months to 19 months at increased risk.

U.S. Preventive Services Task Force (USPSTF)

Premera rolled out USPSTF updates to our health plans on July 1 of this year, or as groups renew. Many plans renew January 1, making it a great time to review the latest USPSTF updates.

Visit our medical policy and coding updates page for more information about preventive coverage and benefits. Resources will be updated on/after effective dates, as applicable.