are well child visits free without insurance

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Preventive care benefits for children

Coverage for children’s preventive health services.

A fixed amount ($20, for example) you pay for a covered health care service after you've paid your deductible.

Refer to glossary for more details.

The percentage of costs of a covered health care service you pay (20%, for example) after you've paid your deductible.

The amount you pay for covered health care services before your insurance plan starts to pay. With a $2,000 deductible, for example, you pay the first $2,000 of covered services yourself.

Alcohol, tobacco, and drug use assessments for adolescents
Autism screening for children at 18 and 24 months
Behavioral assessments for children: Age 0 to 11 months , 1 to 4 years , 5 to 10 years , 11 to 14 years , 15 to 17 years

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Blood pressure screening for children: Age 0 to 11 months , 1 to 4 years , 5 to 10 years , 11 to 14 years , 15 to 17 years
Blood screening for newborns
Depression screening for adolescents beginning routinely at age 12
Developmental screening for children under age 3
Fluoride supplements for children without fluoride in their water source
Fluoride varnish for all infants and children as soon as teeth are present
Gonorrhea preventive medication for the eyes of all newborns
Hematocrit or hemoglobin screening for all children
Hemoglobinopathies or sickle cell screening for newborns
Hepatitis B screening for adolescents at higher risk
HIV screening for adolescents at higher risk
Hypothyroidism screening for newborns
PrEP (pre-exposure prophylaxis) HIV prevention medication for HIV-negative adolescents at high risk for getting HIV through sex or injection drug use
Chickenpox (Varicella)
Diphtheria, tetanus, and pertussis (DTaP)
Haemophilus influenza type b
Hepatitis A
Hepatitis B
Human Papillomavirus (HPV)
Inactivated Poliovirus
Influenza (flu shot)
Meningococcal
Pneumococcal
Obesity screening and counseling
Phenylketonuria (PKU) screening for newborns
Sexually transmitted infection (STI) prevention counseling and screening for adolescents at higher risk
Tuberculin testing for children at higher risk of tuberculosis: Age 0 to 11 months , 1 to 4 years , 5 to 10 years , 11 to 14 years , 15 to 17 years
Vision screening for all children
Well-baby and well-child visits

More information about preventive services for children

Preventive services for children age 0 to 11 months
Preventive services for children age 1 to 4 years
Preventive services for children age 5 to 10 years
Preventive services for children age 11 to 14 years
Preventive services for children age 15 to 17 years

Preventive Health Care Visits in Children

Scheduled visits to the doctor (also called well-child visits) provide parents with information about their child's growth and development. Such visits also give parents an opportunity to ask questions and seek advice, for example, about toilet training .

The American Academy of Pediatrics recommends that after the first year of life children should see their doctor for preventive health care visits at 12, 15, 18, 24, and 30 months of age and then yearly until age 10. Visits can be made more often based on the advice of the doctor or the needs of the family.

Examination

At each visit, several measurements are taken, screening procedures are done, and vaccinations are given depending on the schedule.

Height and weight are checked, and head circumference is measured until the child is 36 months old. Good growth is one indicator that the child is generally healthy. The child's actual size is not nearly as important as whether the child stays at or near the same percentile on the height and weight charts at each visit. A child who is always in the 10th percentile is likely fine (although smaller than most children of the same age), whereas a child who drops from the 35th percentile to the 10th may have a medical problem.

Beginning at age 3, blood pressure is measured at each visit.

The doctor also monitors how the child has progressed developmentally (see Childhood Development ) since the last visit. For example, the doctor may want to know whether an 18-month-old child has begun speaking or whether a 6-year-old child has begun reading a few words (see table Developmental Milestones From Ages 18 Months to 6 Years ). In the same way, doctors often ask age-appropriate questions about the child's behavior. Does the 18-month-old child have tantrums ? Does the 2-year-old child sleep through the night ? Does the 6-year-old child wet the bed at night ? Parents and doctors can discuss these types of behavioral and developmental issues during the preventive health care visits and together design approaches to address any issues.

Finally, the doctor does a complete physical examination. In addition to examining the child from head to toe, including the heart, lungs, abdomen, genitals, spine, arms, legs, head, neck, eyes, ears, nose, mouth, and teeth, the doctor may ask the child to perform some age-appropriate tasks. To check gross motor skills (such as walking and running), the doctor may ask a 4-year-old child to hop on one foot. To check fine motor skills (manipulating small objects with the hands), the child may be asked to draw a picture or copy some shapes.

Preventive visits should include a check of vision and hearing. Vision screening may begin at 3 years of age, if children are cooperative, but is recommended at 4 and 5 years of age. Parents should let the doctor know before then if they have any concerns about their child's vision. At this age, vision tests include the use of charts and testing machines.

Hearing tests, after the newborn testing, typically begin at 4 years of age, but parents should let the doctor know before then if they have any concerns about their child's hearing.

Some children may need to have their blood checked for anemia or an increased level of lead .

Children who are at risk of having high cholesterol should have a blood test between the ages of 2 years and 10 years. Children at risk include those who have a family history of high cholesterol levels, heart attack, or stroke or have risk factors for heart disease (for example, diabetes, obesity, or high blood pressure). All children should have a cholesterol test at age 9 to 11 years and again at age 17 to 21 years.

Children are screened for tuberculosis (TB) risk factors with a questionnaire at all well-child visits. Risk factors include exposure to TB, being born in or having traveled to areas of the world where TB is common (countries other than the United States, Canada, Australia, and New Zealand and Western and North European countries), having a family member with TB, and having parents or close contacts who are recent immigrants from an area where TB is common or who have recently been in jail. Those with risk factors then usually have tuberculosis screening tests done.

The age of the child and various other factors determine whether other tests are done.

Child safety is discussed during preventive visits. Specific safety concerns are based on the age of the child. For example, the discussion might be focused on bicycle safety for a 6-year-old child. The following examples of injury prevention apply to children aged 12 months to 4 years:

Use an age-appropriate and weight-appropriate car seat. (Infants and toddlers should ride rear-facing until they outgrow the rear-facing weight or height limits of a convertible car seat. Convertible car seats have limits that will allow most children to ride rear-facing up to age 2 years. Once they are 2 years old or, regardless of age, have outgrown their rear-facing car seat, toddlers should sit in a forward-facing car seat with harness straps for as long as possible based on weight and height limits.)

Place car seats in the back seat of the vehicle.

Review automobile safety both as passenger and pedestrian.

Tie up window cords to avoid strangulation.

Use safety caps and latches.

Prevent falls.

Remove handguns from the home.

Closely supervise children while in or near any body of water (for example, bathtubs, pools, spas, wading pools, ponds, irrigation ditches, or any other standing water). Children 1 year of age and older should have swim lessons and should wear a life jacket while swimming and always while boating.

Image courtesy of the Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control ( Transportation Safety Resources ). This guidance from the CDC is for the United States, and regulations may differ in other countries.

In addition to those in the list above, the following examples of injury prevention apply to children age 5 years and older:

Use a forward-facing car seat with a harness for as long as possible (until children outgrow the weight or height limits for the car seat) and then use a belt-positioning booster seat until the vehicle seat belt fits properly (typically when children have reached 4 feet 9 inches in height and are between 8 years and 12 years of age).

Have children under 13 years of age restrained with a seat belt in the back seat of the vehicle.

If the vehicle does not have a back seat, disable the air bag in the front passenger seat.

Have children wear a bicycle helmet and protective sports gear.

Instruct children about safe street crossing.

Closely supervise swimming and sometimes have children wear a life jacket while swimming and always while boating.

The doctor may also emphasize other safety topics, such as the importance of installing and maintaining smoke alarms and of keeping potential toxins (such as cleaners and drugs) and firearms (guns) out of the reach of children. Parents should take the opportunity to bring up topics that are most relevant to their unique family situation. As children get older, they can be active participants in these discussions.

Nutrition and exercise

Parents can help prevent obesity and type 2 diabetes by establishing healthy eating patterns and promoting regular exercise. Parents should provide children with a variety of healthy foods, including fruits and vegetables along with sources of protein. Regular meals and small nutritious snacks encourage healthy eating in even a picky preschooler. Although children may avoid some healthy foods, such as broccoli or beans, for a period of time, it is important to continue to offer healthy foods. In addition, parents should limit the child's intake of fruit juices, which, despite their seemingly healthy origin, are mainly sugar water. Some children lose their appetite for food at mealtime if they drink too much fruit juice. Parents should guide children away from frequent snacking and foods that are high in calories, salt, and sugar.

Exercising and maintaining good physical and emotional health are very beneficial for children. Playing outdoors with the family or participating on an athletic team is a good way to encourage children to exercise and prevent obesity.

Screen time (for example, television, video games, cell phones and other handheld devices, and noneducational computer time) may result in inactivity and obesity. Limits on the time a child spends using devices with screens should start at birth and be maintained throughout adolescence.

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Doctor Visits

Make the Most of Your Teen’s Visit to the Doctor (Ages 15 to 17 Years)

Health care provider talking with teen girl

Take Action

Teens ages 15 to 17 years need to go to the doctor or nurse for a “well-child visit” once a year.

A well-child visit is when you take your teen to the doctor to make sure they’re healthy and developing normally. This is different from other visits for sickness or injury.

At a well-child visit, the doctor or nurse can help catch any problems early, when they may be easier to treat.

Learn what to expect so you can make the most of each visit.

Child Development

How do i know if my teen is growing and developing on schedule.

Your teen’s doctor or nurse can help you identify “developmental milestones,” or signs to look for that show your teen is developing normally. This is an important part of the well-child visit.

Some developmental milestones are related to your teen’s behavior and learning, and others are about physical changes in your teen’s body.

See a complete list of developmental milestones for your teen .

Behavior Changes

What are some changes i might see in my teen’s behavior.

Developmental milestones for teens ages 15 to 17 years include:

Spending less time with family and more time with friends
Worrying more about the future (like going to college or finding a job)
Thinking more about romantic relationships and sex
Trying new things like new sports or hobbies — or possibly experimenting with tobacco, alcohol, or drugs

This is also a time when some teens may start showing signs of depression, anxiety, or eating disorders. That’s why it’s important to:

Make sure the doctor screens your teen for depression
Have your teen screened for anxiety

Physical Changes

What are some physical changes my teen is going through.

Teens ages 15 to 17 years may be nearing the end of puberty. Puberty is when a child’s body develops into an adult’s body.

Get more information about puberty to share with your daughter
Get more information about puberty to share with your son

Teens might not ask you questions about sex, their bodies, or relationships. That’s why it’s a good idea for you to start the conversation. You can also encourage your teen to ask the doctor or nurse any questions they have about body changes or other health concerns.

Learn how to talk with your teen about sex .

Take these steps to help you and your teen get the most out of well-child visits.

Gather important information.

Take any medical records you have to the appointment, including a record of vaccines (shots) your teen has received.

Make a list of any important changes in your teen’s life since the last visit, like a:

New brother or sister
Separation or divorce — or a parent spending time in jail or prison
New school or a move to a new neighborhood
Serious illness or death of a friend or family member

Use this tool to keep track of your teen’s family health history .

Help your teen get more involved in visits to the doctor.

The doctor will probably ask you to leave the room during part of the visit, usually the physical exam. This lets your teen develop a relationship with the doctor or nurse and ask questions in private. It’s an important step in teaching your teen to take control of their health care.

Your teen can also:

Call to schedule appointments
Help you fill out medical forms
Write down questions for the doctor or nurse

For more ideas, check out these tips to help teens take charge of their health care . You can also share this list of questions for the doctor with your teen .

What about cost?

Under the Affordable Care Act, insurance plans must cover well-child visits. Depending on your insurance plan, you may be able to get well-child visits at no cost to you. Check with your insurance company to find out more.

Your teen may also qualify for free or low-cost health insurance through Medicaid or the Children’s Health Insurance Program (CHIP). Learn about coverage options for your family.

If you don’t have insurance, you may still be able to get free or low-cost well-child visits. Find a health center near you and ask about well-child visits.

To learn more, check out these resources:

Free preventive care for children covered by the Affordable Care Act
How the Affordable Care Act protects you and your family
Understanding your health insurance and how to use it [PDF - 698 KB]

Ask Questions

Make a list of questions you want to ask the doctor..

Before the well-child visit, write down 3 to 5 questions you have. This visit is a great time to ask the doctor or nurse any questions about:

A health condition your teen has (like acne or asthma)
Changes in your teen’s behavior or mood
Loss of interest in favorite activities
Tobacco, alcohol, or drug use
Problems at school (like learning challenges or not wanting to go to school)

Here are some questions you may want to ask:

Is my teen up to date on vaccines?
How can I make sure my teen is getting enough physical activity?
How can I help my family eat healthy?
How can I help my teen succeed at school?
How can our family set rules more effectively?
How can I help my teen become a safe driver?
How can I talk with my teen about tobacco, alcohol, and drugs?

Take a notepad, smartphone, or tablet and write down the answers so you can remember them later.

Ask what to do if your teen gets sick.

Make sure you know how to get in touch with a doctor or nurse when the office is closed. Ask how to get hold of the doctor on call, or if there's a nurse information service you can call at night or on the weekend.

What to Expect

Know what to expect..

During each well-child visit, the doctor or nurse will ask you questions, do a physical exam, and update your teen’s medical history. You and your teen will also be able to ask your questions and discuss any problems.

The doctor or nurse will ask your teen questions.

The doctor or nurse may ask about:

Behavior — Do you have trouble following directions at home or at school?
Health — Do you often get headaches or have other kinds of pain?
Safety — Do you always wear a seatbelt in the car? Do you and your friends use tobacco, alcohol, or drugs?
School and activities — Do you look forward to going to school? What do you like to do after school?
Family and friends — Have there been any changes in your family recently? Do you have close friends?
Emotions — Do you often feel sad or bored? Do you often feel scared or very worried? Is there someone you trust who you can talk to about problems?
Sexuality — Do you have any questions about your body? Have you talked with your parents about dating and sex? Are you dating anyone now?
The future — Have you started to think about what you want to do after high school?

The answers to questions like these will help the doctor or nurse make sure your teen is healthy, safe, and developing normally.

Physical Exam

The doctor or nurse will also check your teen’s body..

To check your teen’s body, the doctor or nurse will:

Measure height and weight and figure out your teen's body mass index (BMI)
Check your teen’s blood pressure
Check your teen's vision and hearing
Check your teen’s body parts (called a physical exam)
Decide if your teen needs any lab tests, like a blood test
Give your teen vaccines they need

Behavior and Emotions

The doctor or nurse will pay special attention to signs of certain issues. .

The doctor or nurse will offer additional help if your teen may:

Be depressed
Have anxiety
Struggle with an eating disorder
Use tobacco, alcohol, or other drugs
Experience any kind of violence

And if your teen may be having sex, the doctor or nurse will talk about preventing STIs (sexually transmitted infections) — also called STDs (sexually transmitted diseases) — and pregnancy. Learn how to talk with your teen about preventing STIs .

The doctor or nurse will make sure you and your teen have the resources you need.

This may include telling you and your teen about:

Websites or apps that have helpful health information
Organizations in your community where you can go for help

If needed, the doctor or nurse may also refer your teen to a specialist.

Content last updated February 16, 2024

Reviewer Information

This information on well-child visits was adapted from materials from the Centers for Disease Control and Prevention and the National Institutes of Health.

Reviewed by: Sara B. Kinsman, M.D., Ph.D. Director, Division of Child, Adolescent and Family Health Maternal and Child Health Bureau Health Resources and Services Administration

You may also be interested in:

are well child visits free without insurance

Talk to Your Kids About Tobacco, Alcohol, and Drugs

Get Your Teen Screened for Depression

Help Your Child Stay at a Healthy Weight

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Child well visits, birth to 15 months

Child well visit checklist
Quiz: Child well-being and immunizations

Checking in: Questions to ask at your child's well visits

Welcoming a new child is exciting. But caring for a baby can also leave you with a lot of unanswered questions. Your baby’s care provider can help. From giving immunizations to offering you feeding tips, care providers help your baby grow up healthy. That includes making sure you have the answers and support you need.

A note about immunizations at child well visits

Your child’s care provider will give your baby immunizations during most visits. Immunizations work better and reduce the risk of infection by working with the body's natural defenses to help safely develop immunity to disease. Keeping your baby on schedule is also key, so don’t forget to schedule visits on time.

Learn what to ask at your child's well visits

Preparation is key for a stress-free appointment. Your baby should go to at least 8 child well visits before they are 15 months old. Knowing what will happen at each of these appointments can help you get ready. Knowing what to pack for your visit and questions you might ask when you get there can make your life easier. Watch the videos and view the questions below to get ready for each early child well visit.

Child Well Visits: Newborn

Video transcript.

Screen 1: What to expect at your baby’s appointment – Newborn

Screen 2: Your newborn will need a checkup before going home.

Screen 3: What to expect before you leave the hospital:

Physical checkup (measurements, vitals).
Screenings: Critical congenital heart defect, vision, hearing, newborn bilirubin, blood (check for disorders).
Developmental and behavioral assessment.
Immunizations: HepB.

Screen 4: Before you leave:

Make sure your contact information is current.
Schedule your next appointment.

Screen 5: In light of COVID-19, remember to practice social distancing at your well-child visits. Wash your hands often and wear a mask. Contact your care provider with questions about your visit.

Screen 6: UnitedHealthcare Logo

Your newborn will need a checkup before going home from the hospital. Watch the video to learn what screenings and immunizations you can expect at your child’s first appointment.

3 to 5-day visit

Child well visits: 3 to 5-day visit.

Screen 1: What to expect at your baby’s appointment – 3-5 Days

Screen 2: Early well-child visits and immunizations set your baby up for a healthy future.

Screen 3: What to expect at your child’s appointment:

Physical checkup: Measurements, vitals.
Umbilical cord examination.
Screenings: Vision, hearing, blood (check for disorders).
Review screenings done at birth.

Screen 4: You’ll also talk about if baby can:

Suck to eat
Grasp your finger
React when startled

Screen 5: Before you leave:

Screen 6: In light of COVID-19, remember to practice social distancing at your well-child visits. Wash your hands often and wear a mask. Contact your care provider with questions about your visit.

UnitedHealthcare Logo

Watch the video to get an idea of what to expect at your appointment

In addition, here are some questions you may want to ask:

How can I keep my baby comfortable and safe from seasonal weather?
What can I do to make breastfeeding more comfortable for me and baby?
When will my baby gain more weight?
Should I always put my baby to sleep on their back?
How do I care for my baby’s umbilical cord?
How often should my baby get a bath?
How do I calm and soothe my baby?

1-month visit

Child well visits: 1 month appointment.

Screen 1: What to expect at your baby’s appointment – 1 Month

Immunizations: HepB.
Postpartum depression screening (for mothers).
Raise hands
Focus on your face

Screen 7: UnitedHealthcare Logo

When will my baby sleep through the night?
What should I do for the peeling skin on my baby’s head?
How do I care for my infant's skin?
What is a normal number of wet or soiled diapers I should change every day?
Are there programs to help me buy formula or breast pumps?

2-month visit

Child well visits: 2 month appointment.

Screen 1: What to expect at your baby’s appointment – 2 Months

Physical checkup: (measurements, vitals).
Screenings: Vision, hearing.
Immunizations: DTaP, Hib, IPV, RV, HepB, PCV13.
Developmental assessment.
Turn and lift head
Kick while laying on back
Notice hands
Follow objects with eyes
How often should my baby be eating?
Should I be using formula in addition to breastfeeding?
How can I keep my baby comfortable after immunizations?
How can I find childcare I can trust?
When should I stop swaddling my baby?
I’ve been feeling sad and anxious since delivering my baby. What should I do?
What is “tummy time”?

4-month visit

Child well visits: 4 month appointment.

Screen 1: What to expect at your baby’s appointment – 4 Months

Roll onto tummy
Reach for objects
Watch an object move
Laugh and giggle

Screen 7: UnitedHealthcare Logo

Is Tylenol safe to give my baby for a fever?
How can I help my baby have healthy teeth?
How can I soothe my baby during teething?
How can we begin to create a sleeping routine?
How long should my baby spend doing “tummy time” each day?
How long should my baby nap each day?

6-month visit

Child well visits: 6 month appointment.

Screen 1: What to expect at your baby’s appointment – 6 Months

Screenings: Vision, hearing, oral health.
Immunizations: DTaP, Hib, IPV, RV, HepB, PCV13, IIV.
Roll in both directions
Play with toes
Hold a bottle
Sit with good head control
When and how should I introduce foods other than breastmilk or formula?
How can I wean my baby off night feedings?
How long should my baby use a pacifier?
Can my baby sleep with a favorite blanket or toy?
When can my baby start drinking from a sippy cup?

9-month visit

Child well visits: 9 month appointment.

Screen 1: What to expect at your baby’s appointment – 9 Months

Screenings: Vision, hearing, anemia, lead, oral health.
Immunizations: IIV.
Sit unassisted
Crawl and pull up to stand
Work to get toys that are out of reach
I think my baby is behind in development (e.g., crawling). What can I do to help?
What do I need to babyproof in my home once my baby can crawl?
Should I be brushing my baby’s new teeth?
How long should my baby be sleeping at night?
How long should I let my baby cry at night?

12-month visit

Child well visits: 12 month appointment.

Screen 1: What to expect at your baby’s appointment – 12 Months

Screenings: Vision, hearing, lead, oral health.
Immunizations: MMR, HepA, Varicella, PCV13, IIV.
Walk while holding onto something
Use gestures to get things
Eat solid foods with fingers
Say more than one word
Respond to name
What should I do when baby pulls my hair or bites?
Are my baby’s sleep patterns normal?
How can I treat diaper rash?
What can I do about sore arms and back from holding my baby?
Should my baby nap at the same time each day?
How do I keep my child safe as they learn to walk and explore?

15-month visit

Child well visits: 15 month appointment.

Screen 1: What to expect at your baby’s appointment – 15 Months

Immunizations: DTaP, Hib, IIV.
Walk and run
Squat and stand back up
Throw or kick a ball
Point for things
When should my baby switch from a crib to a bed?
How much juice or milk should my baby be drinking?
Should my baby have screen time?
When should my baby go to the dentist?
When should I switch to a front-facing car seat?

Wellness visits are also important for your child after 15 months

As your child grows, it’s important to continue to have regular checkups with your health care provider. You can view checklists for preventive care visits at every age, from 1 month to adulthood.

Looking for resources to help support you and your child?

Most health insurance plans cover early child well visits or provide assistance. Call the number on your insurance card for more details.
If you are a UnitedHealthcare Community Plan member, you may have access to our Healthy First Steps program , which can help you find a care provider, schedule well-child visits, connect with educational and community resources and more. To get started, call 1-800-599-5985 , TTY 711, Monday through Friday, from 8 a.m. to 5 p.m. 1
If you need help getting to an appointment, or getting formula or healthy food, call the number on your insurance card.
If you are having a hard time getting food or are experiencing unemployment, your care provider may be able to connect you with resources that can help.

Clinical Examination

The history should include a brief review of birth history; prematurity can be associated with complex medical conditions. 1 Evaluate breastfed infants for any feeding problems, 2 and assess formula-fed infants for type and quantity of iron-fortified formula being given. 3 For children eating solid foods, feeding history should include everything the child eats and drinks. Sleep, urination, defecation, nutrition, dental care, and child safety should be reviewed. Medical, surgical, family, and social histories should be reviewed and updated. For newborns, review the results of all newborn screening tests ( Table 1 4 – 7 ) and schedule follow-up visits as necessary. 2

PHYSICAL EXAMINATION

A comprehensive head-to-toe examination should be completed at each well-child visit. Interval growth should be reviewed by using appropriate age, sex, and gestational age growth charts for height, weight, head circumference, and body mass index if 24 months or older. The Centers for Disease Control and Prevention (CDC)-recommended growth charts can be found at https://www.cdc.gov/growthcharts/who_charts.htm#The%20WHO%20Growth%20Charts . Percentiles and observations of changes along the chart's curve should be assessed at every visit. Include assessment of parent/caregiver-child interactions and potential signs of abuse such as bruises on uncommonly injured areas, burns, human bite marks, bruises on nonmobile infants, or multiple injuries at different healing stages. 8

The USPSTF and AAP screening recommendations are outlined in Table 2 . 3 , 9 – 27 A summary of AAP recommendations can be found at https://www.aap.org/en-us/Documents/periodicity_schedule.pdf . The American Academy of Family Physicians (AAFP) generally adheres to USPSTF recommendations. 28

MATERNAL DEPRESSION

Prevalence of postpartum depression is around 12%, 22 and its presence can impair infant development. The USPSTF and AAP recommend using the Edinburgh Postnatal Depression Scale (available at https://www.aafp.org/afp/2010/1015/p926.html#afp20101015p926-f1 ) or the Patient Health Questionnaire-2 (available at https://www.aafp.org/afp/2012/0115/p139.html#afp20120115p139-t3 ) to screen for maternal depression. The USPSTF does not specify a screening schedule; however, based on expert opinion, the AAP recommends screening mothers at the one-, two-, four-, and six-month well-child visits, with further evaluation for positive results. 23 There are no recommendations to screen other caregivers if the mother is not present at the well-child visit.

PSYCHOSOCIAL

With nearly one-half of children in the United States living at or near the poverty level, assessing home safety, food security, and access to safe drinking water can improve awareness of psychosocial problems, with referrals to appropriate agencies for those with positive results. 29 The prevalence of mental health disorders (i.e., primarily anxiety, depression, behavioral disorders, attention-deficit/hyperactivity disorder) in preschool-aged children is around 6%. 30 Risk factors for these disorders include having a lower socioeconomic status, being a member of an ethnic minority, and having a non–English-speaking parent or primary caregiver. 25 The USPSTF found insufficient evidence regarding screening for depression in children up to 11 years of age. 24 Based on expert opinion, the AAP recommends that physicians consider screening, although screening in young children has not been validated or standardized. 25

DEVELOPMENT AND SURVEILLANCE

Based on expert opinion, the AAP recommends early identification of developmental delays 14 and autism 10 ; however, the USPSTF found insufficient evidence to recommend formal developmental screening 13 or autism-specific screening 9 if the parents/caregivers or physician have no concerns. If physicians choose to screen, developmental surveillance of language, communication, gross and fine movements, social/emotional development, and cognitive/problem-solving skills should occur at each visit by eliciting parental or caregiver concerns, obtaining interval developmental history, and observing the child. Any area of concern should be evaluated with a formal developmental screening tool, such as Ages and Stages Questionnaire, Parents' Evaluation of Developmental Status, Parents' Evaluation of Developmental Status-Developmental Milestones, or Survey of Well-Being of Young Children. These tools can be found at https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/Screening/Pages/Screening-Tools.aspx . If results are abnormal, consider intervention or referral to early intervention services. The AAP recommends completing the previously mentioned formal screening tools at nine-, 18-, and 30-month well-child visits. 14

The AAP also recommends autism-specific screening at 18 and 24 months. 10 The USPSTF recommends using the two-step Modified Checklist for Autism in Toddlers (M-CHAT) screening tool (available at https://m-chat.org/ ) if a physician chooses to screen a patient for autism. 10 The M-CHAT can be incorporated into the electronic medical record, with the possibility of the parent or caregiver completing the questionnaire through the patient portal before the office visit.

IRON DEFICIENCY

Multiple reports have associated iron deficiency with impaired neurodevelopment. Therefore, it is essential to ensure adequate iron intake. Based on expert opinion, the AAP recommends supplements for preterm infants beginning at one month of age and exclusively breastfed term infants at six months of age. 3 The USPSTF found insufficient evidence to recommend screening for iron deficiency in infants. 19 Based on expert opinion, the AAP recommends measuring a child's hemoglobin level at 12 months of age. 3

Lead poisoning and elevated lead blood levels are prevalent in young children. The AAP and CDC recommend a targeted screening approach. The AAP recommends screening for serum lead levels between six months and six years in high-risk children; high-risk children are identified by location-specific risk recommendations, enrollment in Medicaid, being foreign born, or personal screening. 21 The USPSTF does not recommend screening for lead poisoning in children at average risk who are asymptomatic. 20

The USPSTF recommends at least one vision screening to detect amblyopia between three and five years of age. Testing options include visual acuity, ocular alignment test, stereoacuity test, photoscreening, and autorefractors. The USPSTF found insufficient evidence to recommend screening before three years of age. 26 The AAP, American Academy of Ophthalmology, and the American Academy of Pediatric Ophthalmology and Strabismus recommend the use of an instrument-based screening (photoscreening or autorefractors) between 12 months and three years of age and annual visual acuity screening beginning at four years of age. 31

IMMUNIZATIONS

The AAFP recommends that all children be immunized. 32 Recommended vaccination schedules, endorsed by the AAP, the AAFP, and the Advisory Committee on Immunization Practices, are found at https://www.cdc.gov/vaccines/schedules/hcp/child-adolescent.html . Immunizations are usually administered at the two-, four-, six-, 12-, and 15- to 18-month well-child visits; the four- to six-year well-child visit; and annually during influenza season. Additional vaccinations may be necessary based on medical history. 33 Immunization history should be reviewed at each wellness visit.

Anticipatory Guidance

Injuries remain the leading cause of death among children, 34 and the AAP has made several recommendations to decrease the risk of injuries. 35 – 42 Appropriate use of child restraints minimizes morbidity and mortality associated with motor vehicle collisions. Infants need a rear-facing car safety seat until two years of age or until they reach the height or weight limit for the specific car seat. Children should then switch to a forward-facing car seat for as long as the seat allows, usually 65 to 80 lb (30 to 36 kg). 35 Children should never be unsupervised around cars, driveways, and streets. Young children should wear bicycle helmets while riding tricycles or bicycles. 37

Having functioning smoke detectors and an escape plan decreases the risk of fire- and smoke-related deaths. 36 Water heaters should be set to a maximum of 120°F (49°C) to prevent scald burns. 37 Infants and young children should be watched closely around any body of water, including water in bathtubs and toilets, to prevent drowning. Swimming pools and spas should be completely fenced with a self-closing, self-latching gate. 38

Infants should not be left alone on any high surface, and stairs should be secured by gates. 43 Infant walkers should be discouraged because they provide no benefit and they increase falls down stairs, even if stair gates are installed. 39 Window locks, screens, or limited-opening windows decrease injury and death from falling. 40 Parents or caregivers should also anchor furniture to a wall to prevent heavy pieces from toppling over. Firearms should be kept unloaded and locked. 41

Young children should be closely supervised at all times. Small objects are a choking hazard, especially for children younger than three years. Latex balloons, round objects, and food can cause life-threatening airway obstruction. 42 Long strings and cords can strangle children. 37

DENTAL CARE

Infants should never have a bottle in bed, and babies should be weaned to a cup by 12 months of age. 44 Juices should be avoided in infants younger than 12 months. 45 Fluoride use inhibits tooth demineralization and bacterial enzymes and also enhances remineralization. 11 The AAP and USPSTF recommend fluoride supplementation and the application of fluoride varnish for teeth if the water supply is insufficient. 11 , 12 Begin brushing teeth at tooth eruption with parents or caregivers supervising brushing until mastery. Children should visit a dentist regularly, and an assessment of dental health should occur at well-child visits. 44

SCREEN TIME

Hands-on exploration of their environment is essential to development in children younger than two years. Video chatting is acceptable for children younger than 18 months; otherwise digital media should be avoided. Parents and caregivers may use educational programs and applications with children 18 to 24 months of age. If screen time is used for children two to five years of age, the AAP recommends a maximum of one hour per day that occurs at least one hour before bedtime. Longer usage can cause sleep problems and increases the risk of obesity and social-emotional delays. 46

To decrease the risk of sudden infant death syndrome (SIDS), the AAP recommends that infants sleep on their backs on a firm mattress for the first year of life with no blankets or other soft objects in the crib. 45 Breastfeeding, pacifier use, and room sharing without bed sharing protect against SIDS; infant exposure to tobacco, alcohol, drugs, and sleeping in bed with parents or caregivers increases the risk of SIDS. 47

DIET AND ACTIVITY

The USPSTF, AAFP, and AAP all recommend breastfeeding until at least six months of age and ideally for the first 12 months. 48 Vitamin D 400 IU supplementation for the first year of life in exclusively breastfed infants is recommended to prevent vitamin D deficiency and rickets. 49 Based on expert opinion, the AAP recommends the introduction of certain foods at specific ages. Early transition to solid foods before six months is associated with higher consumption of fatty and sugary foods 50 and an increased risk of atopic disease. 51 Delayed transition to cow's milk until 12 months of age decreases the incidence of iron deficiency. 52 Introduction of highly allergenic foods, such as peanut-based foods and eggs, before one year decreases the likelihood that a child will develop food allergies. 53

With approximately 17% of children being obese, many strategies for obesity prevention have been proposed. 54 The USPSTF does not have a recommendation for screening or interventions to prevent obesity in children younger than six years. 54 The AAP has made several recommendations based on expert opinion to prevent obesity. Cessation of breastfeeding before six months and introduction of solid foods before six months are associated with childhood obesity and are not recommended. 55 Drinking juice should be avoided before one year of age, and, if given to older children, only 100% fruit juice should be provided in limited quantities: 4 ounces per day from one to three years of age and 4 to 6 ounces per day from four to six years of age. Intake of other sugar-sweetened beverages should be discouraged to help prevent obesity. 45 The AAFP and AAP recommend that children participate in at least 60 minutes of active free play per day. 55 , 56

Data Sources: Literature search was performed using the USPSTF published recommendations ( https://www.uspreventiveservicestaskforce.org/BrowseRec/Index/browse-recommendations ) and the AAP Periodicity table ( https://www.aap.org/en-us/Documents/periodicity_schedule.pdf ). PubMed searches were completed using the key terms pediatric, obesity prevention, and allergy prevention with search limits of infant less than 23 months or pediatric less than 18 years. The searches included systematic reviews, randomized controlled trials, clinical trials, and position statements. Essential Evidence Plus was also reviewed. Search dates: May through October 2017.

Gauer RL, Burket J, Horowitz E. Common questions about outpatient care of premature infants. Am Fam Physician. 2014;90(4):244-251.

American Academy of Pediatrics; Committee on Fetus and Newborn. Hospital stay for healthy term newborns. Pediatrics. 2010;125(2):405-409.

Baker RD, Greer FR Committee on Nutrition, American Academy of Pediatrics. Diagnosis and prevention of iron deficiency and iron-deficiency anemia in infants and young children (0–3 years of age). Pediatrics. 2010;126(5):1040-1050.

Mahle WT, Martin GR, Beekman RH, Morrow WR Section on Cardiology and Cardiac Surgery Executive Committee. Endorsement of Health and Human Services recommendation for pulse oximetry screening for critical congenital heart disease. Pediatrics. 2012;129(1):190-192.

American Academy of Pediatrics Newborn Screening Authoring Committee. Newborn screening expands: recommendations for pediatricians and medical homes—implications for the system. Pediatrics. 2008;121(1):192-217.

American Academy of Pediatrics, Joint Committee on Infant Hearing. Year 2007 position statement: principles and guidelines for early hearing detection and intervention programs. Pediatrics. 2007;120(4):898-921.

Maisels MJ, Bhutani VK, Bogen D, Newman TB, Stark AR, Watchko JF. Hyperbilirubinemia in the newborn infant > or = 35 weeks' gestation: an update with clarifications. Pediatrics. 2009;124(4):1193-1198.

Christian CW Committee on Child Abuse and Neglect, American Academy of Pediatrics. The evaluation of suspected child physical abuse [published correction appears in Pediatrics . 2015;136(3):583]. Pediatrics. 2015;135(5):e1337-e1354.

Siu AL, Bibbins-Domingo K, Grossman DC, et al. Screening for autism spectrum disorder in young children: U.S. Preventive Services Task Force recommendation statement. JAMA. 2016;315(7):691-696.

Johnson CP, Myers SM American Academy of Pediatrics Council on Children with Disabilities. Identification and evaluation of children with autism spectrum disorders. Pediatrics. 2007;120(5):1183-1215.

Moyer VA. Prevention of dental caries in children from birth through age 5 years: U.S. Preventive Services Task Force recommendation statement. Pediatrics. 2014;133(6):1102-1111.

Clark MB, Slayton RL American Academy of Pediatrics Section on Oral Health. Fluoride use in caries prevention in the primary care setting. Pediatrics. 2014;134(3):626-633.

Siu AL. Screening for speech and language delay and disorders in children aged 5 years and younger: U.S. Preventive Services Task Force recommendation statement. Pediatrics. 2015;136(2):e474-e481.

Council on Children with Disabilities, Section on Developmental Behavioral Pediatrics, Bright Futures Steering Committee, Medical Home Initiatives for Children with Special Needs Project Advisory Committee. Identifying infants and young children with developmental disorders in the medical home: an algorithm for developmental surveillance and screening [published correction appears in Pediatrics . 2006;118(4):1808–1809]. Pediatrics. 2006;118(1):405-420.

Bibbins-Domingo K, Grossman DC, Curry SJ, et al. Screening for lipid disorders in children and adolescents: U.S. Preventive Services Task Force recommendation statement. JAMA. 2016;316(6):625-633.

National Heart, Lung, and Blood Institute. Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents. October 2012. https://www.nhlbi.nih.gov/sites/default/files/media/docs/peds_guidelines_full.pdf . Accessed May 9, 2018.

Moyer VA. Screening for primary hypertension in children and adolescents: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2013;159(9):613-619.

Flynn JT, Kaelber DC, Baker-Smith CM, et al. Clinical practice guideline for screening and management of high blood pressure in children and adolescents [published correction appears in Pediatrics . 2017;140(6):e20173035]. Pediatrics. 2017;140(3):e20171904.

Siu AL. Screening for iron deficiency anemia in young children: USPSTF recommendation statement. Pediatrics. 2015;136(4):746-752.

U.S. Preventive Services Task Force. Screening for elevated blood lead levels in children and pregnant women. Pediatrics. 2006;118(6):2514-2518.

Screening Young Children for Lead Poisoning: Guidance for State and Local Public Health Officials . Atlanta, Ga.: U.S. Public Health Service; Centers for Disease Control and Prevention; National Center for Environmental Health; 1997.

O'Connor E, Rossom RC, Henninger M, Groom HC, Burda BU. Primary care screening for and treatment of depression in pregnant and post-partum women: evidence report and systematic review for the U.S. Preventive Services Task Force. JAMA. 2016;315(4):388-406.

Earls MF Committee on Psychosocial Aspects of Child and Family Health, American Academy of Pediatrics. Incorporating recognition and management of perinatal and postpartum depression into pediatric practice. Pediatrics. 2010;126(5):1032-1039.

Siu AL. Screening for depression in children and adolescents: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2016;164(5):360-366.

Weitzman C, Wegner L American Academy of Pediatrics Section on Developmental and Behavioral Pediatrics; Committee on Psychosocial Aspects of Child and Family Health; Council on Early Childhood; Society for Developmental and Behavioral Pediatrics; American Academy of Pediatrics. Promoting optimal development: screening for behavioral and emotional problems [published correction appears in Pediatrics . 2015;135(5):946]. Pediatrics. 2015;135(2):384-395.

Grossman DC, Curry SJ, Owens DK, et al. Vision screening in children aged 6 months to 5 years: U.S. Preventive Services Task Force recommendation statement. JAMA. 2017;318(9):836-844.

Donahue SP, Nixon CN Committee on Practice and Ambulatory Medicine, Section on Ophthalmology, American Academy of Pediatrics; American Association of Certified Orthoptists, American Association for Pediatric Ophthalmology and Strabismus, American Academy of Ophthalmology. Visual system assessment in infants, children, and young adults by pediatricians. Pediatrics. 2016;137(1):28-30.

Lin KW. What to do at well-child visits: the AAFP's perspective. Am Fam Physician. 2015;91(6):362-364.

American Academy of Pediatrics Council on Community Pediatrics. Poverty and child health in the United States. Pediatrics. 2016;137(4):e20160339.

Lavigne JV, Lebailly SA, Hopkins J, Gouze KR, Binns HJ. The prevalence of ADHD, ODD, depression, and anxiety in a community sample of 4-year-olds. J Clin Child Adolesc Psychol. 2009;38(3):315-328.

American Academy of Pediatrics Committee on Practice and Ambulatory Medicine, Section on Ophthalmology, American Association of Certified Orthoptists, American Association for Pediatric Ophthalmology and Strabismus, American Academy of Ophthalmology. Visual system assessment of infants, children, and young adults by pediatricians. Pediatrics. 2016;137(1):28-30.

American Academy of Family Physicians. Clinical preventive service recommendation. Immunizations. http://www.aafp.org/patient-care/clinical-recommendations/all/immunizations.html . Accessed October 5, 2017.

Centers for Disease Control and Prevention. Recommended immunization schedule for children and adolescents aged 18 years or younger, United States, 2018. https://www.cdc.gov/vaccines/schedules/hcp/child-adolescent.html . Accessed May 9, 2018.

National Center for Injury Prevention and Control. 10 leading causes of death by age group, United States—2015. https://www.cdc.gov/injury/images/lc-charts/leading_causes_of_death_age_group_2015_1050w740h.gif . Accessed April 24, 2017.

Durbin DR American Academy of Pediatrics Committee on Injury, Violence, and Poison Prevention. Child passenger safety. Pediatrics. 2011;127(4):788-793.

American Academy of Pediatrics Committee on Injury and Poison Prevention. Reducing the number of deaths and injuries from residential fires. Pediatrics. 2000;105(6):1355-1357.

Gardner HG American Academy of Pediatrics Committee on Injury, Violence, and Poison Prevention. Office-based counseling for unintentional injury prevention. Pediatrics. 2007;119(1):202-206.

American Academy of Pediatrics Committee on Injury, Violence, and Poison Prevention. Prevention of drowning in infants, children, and adolescents. Pediatrics. 2003;112(2):437-439.

American Academy of Pediatrics Committee on Injury and Poison Prevention. Injuries associated with infant walkers. Pediatrics. 2001;108(3):790-792.

American Academy of Pediatrics Committee on Injury and Poison Prevention. Falls from heights: windows, roofs, and balconies. Pediatrics. 2001;107(5):1188-1191.

Dowd MD, Sege RD Council on Injury, Violence, and Poison Prevention Executive Committee; American Academy of Pediatrics. Firearm-related injuries affecting the pediatric population. Pediatrics. 2012;130(5):e1416-e1423.

American Academy of Pediatrics Committee on Injury, Violence, and Poison Prevention. Prevention of choking among children. Pediatrics. 2010;125(3):601-607.

Kendrick D, Young B, Mason-Jones AJ, et al. Home safety education and provision of safety equipment for injury prevention (review). Evid Based Child Health. 2013;8(3):761-939.

American Academy of Pediatrics Section on Oral Health. Maintaining and improving the oral health of young children. Pediatrics. 2014;134(6):1224-1229.

Heyman MB, Abrams SA American Academy of Pediatrics Section on Gastroenterology, Hepatology, and Nutrition Committee on Nutrition. Fruit juice in infants, children, and adolescents: current recommendations. Pediatrics. 2017;139(6):e20170967.

Council on Communications and Media. Media and young minds. Pediatrics. 2016;138(5):e20162591.

Moon RY Task Force on Sudden Infant Death Syndrome. SIDS and other sleep-related infant deaths: evidence base for 2016 updated recommendations for a safe infant sleeping environment. Pediatrics. 2016;138(5):e20162940.

American Academy of Pediatrics Section on Breastfeeding. Breastfeeding and the use of human milk. Pediatrics. 2012;129(3):e827-e841.

Wagner CL, Greer FR American Academy of Pediatrics Section on Breastfeeding; Committee on Nutrition. Prevention of rickets and vitamin D deficiency in infants, children, and adolescents [published correction appears in Pediatrics . 2009;123(1):197]. Pediatrics. 2008;122(5):1142-1152.

Huh SY, Rifas-Shiman SL, Taveras EM, Oken E, Gillman MW. Timing of solid food introduction and risk of obesity in preschool-aged children. Pediatrics. 2011;127(3):e544-e551.

Greer FR, Sicherer SH, Burks AW American Academy of Pediatrics Committee on Nutrition; Section on Allergy and Immunology. Effects of early nutritional interventions on the development of atopic disease in infants and children: the role of maternal dietary restriction, breastfeeding, timing of introduction of complementary foods, and hydrolyzed formulas. Pediatrics. 2008;121(1):183-191.

American Academy of Pediatrics Committee on Nutrition. The use of whole cow's milk in infancy. Pediatrics. 1992;89(6 pt 1):1105-1109.

Fleischer DM, Spergel JM, Assa'ad AH, Pongracic JA. Primary prevention of allergic disease through nutritional interventions. J Allergy Clin Immunol Pract. 2013;1(1):29-36.

Grossman DC, Bibbins-Domingo K, Curry SJ, et al. Screening for obesity in children and adolescents: U.S. Preventive Services Task Force recommendation statement. JAMA. 2017;317(23):2417-2426.

Daniels SR, Hassink SG Committee on Nutrition. The role of the pediatrician in primary prevention of obesity. Pediatrics. 2015;136(1):e275-e292.

American Academy of Family Physicians. Physical activity in children. https://www.aafp.org/about/policies/all/physical-activity.html . Accessed January 1, 2018.

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More in AFP

Well-Child Care

Improving infant well-child visits.

High-quality well-child visits can improve children’s health, support caregivers’ behaviors to promote their children’s health, and prevent injury and harm. The American Academy of Pediatrics and Bright Futures recommend nine well-care visits by the time children turn 15 months of age. These visits should include a family-centered health history, physical examination, immunizations, vision and hearing screening, developmental and behavioral assessment, an oral health risk assessment, a social assessment, maternal depression screening, parenting education on a wide range of topics, and care coordination as needed. i When children receive the recommended number of high-quality visits, they are more likely to be up-to-date on immunizations, have developmental concerns recognized early, and are less likely to visit the emergency department. ii , iii , iv , v , vi , vii However, many infants do not receive the recommended number of infant well-child visits.

The Centers for Medicare & Medicaid Services (CMS) offers quality improvement (QI) technical assistance (TA) to help states increase the attendance and quality of well-child visits for Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries ages 0 to 15 months.

QI TA resources , to help state Medicaid and CHIP staff and their QI partners get started improving the use of infant well-child visits for their beneficiaries

Improving Infant Well-Child Visit learning collaborative resources , to share different approaches to improving well-child visit care and state examples

For more information on these materials and other QI TA, please email [email protected] .

QI TA Resources

These resources can help states get started in developing their own infant well-child QI projects:

Getting Started on Quality Improvement Video . This video provides an overview of how Medicaid and CHIP agencies can start a QI project to improve the use of infant well-child visits. The Model for Improvement begins with small tests of change, enabling state teams to “learn their way” toward strong programs and policies.

Driver Diagram and Change Idea Table . A driver diagram is a visual display of what “drives” or contributes to improvements in infant well-child visits. This example of a driver diagram shows the relationship between the primary drivers (the high-level elements, processes, structures, or norms in the system that must change to use and quality of infant well-child visits) and the secondary drivers (the places, steps in a process, time-bound moments, or norms in which changes are made to spur improvement). The document also includes change idea tables, which contain examples of evidence-based or evidence-informed QI interventions to improve the use of infant well-child care. The change ideas were tailored for Medicaid and CHIP.

Measurement Strategy . This document provides examples of measures that can be used to monitor infant well-child care QI projects.

Improving Infant Well-Child Visits: Learning Collaborative Resources

Beginning in 2021, CMS facilitated the two year Infant Well-Child Visit learning collaborative to support state Medicaid and CHIP agencies’ efforts to improve the use of infant well-child visits from 0-15 months of age. The learning collaborative included a webinar series and an affinity group to support state Medicaid and agencies’ quality improvement efforts. The webinars, listed and linked to below, described approaches that states can use to improve attendance and quality of infant well-child visits.

California, Missouri, North Carolina, South Carolina, Texas and Virginia participated in the action-oriented affinity group where teams designed and implemented an infant well-child quality improvement (QI) project in their state with tailored TA from CMS. Learnings from participating states can be found in the state highlights brief.

Learning Collaborative Webinar Series

State Spotlights Webinar on Improving Infant-Well Child Care ( Video ) ( Transcript ). This 2024 webinar spotlighted several state QI projects from the affinity group, highlighting their strategies, partnerships, and lessons learned.

Using Payment, Policy and Partnerships to Improve Infant Well-Child Care ( Audio )( Transcript ). This August 2021 webinar focused on Medicaid and CHIP payment incentives, managed care contracts, and other strategies that can increase the use and quality of infant well-child visits and advance equity. Speakers from the CMS and Mathematica introduced CMS’ Maternal and Infant Health Initiative and shared the importance of high-quality well-child visits and the opportunities within Medicaid and CHIP to impact infant health. Speakers from Pennsylvania and Texas’ Medicaid and CHIP agencies described their efforts to expand and incentivize participation in infant well-child visits, such as through value-based purchasing, performance improvement projects, CHIP Health Services Initiatives (HSIs), and partnerships with aligned service providers like the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). State presenters offered insights into ways to incentivize efforts to close gaps in care, engage families, and improve performance on quality measures. During the Q&A session, presenters discussed the impact of the COVID-19 pandemic on well-child care, the potential of using telehealth or hybrid visits to increase access, and incentives for managed care entities, and addressing the social determinants of health in value-based payment strategies.

Improving Quality and Utilization of Infant Well-Child Visits ( Audio )( Transcript ). This September 2021 webinar focused on the characteristics of a high-performing system of well-child health care. CMS and Mathematica presenters shared the Maternal and Infant Health Initiative’s Theory of Change. Speakers from Washington and Arkansas Medicaid and CHIP agencies discussed how their states have achieved high rates of participation in infant well-child visits and how they use data to monitor performance and disparities and ensure access to services. Washington shared insights on leveraging collaborative performance improvement projects to identify and address barriers to care. Arkansas discussed the state’s per member per month incentives for performance and minimum performance measures for infant well-child visit rates. During the Q&A session, presenters highlighted efforts to improve health equity, engage parents and providers, and leverage performance measures and quality tools to improve attendance at infant well-child visits.

Models of Care that Drive Improvement in Infant Well-Child Visits ( Audio )( Transcript ). In this September 2021 webinar, three states—Oregon, Michigan, and North Carolina—shared approaches to designing and implementing models of care associated with improved infant well-child visit participation, including patient-centered medical homes (PCMHs) and home visiting. States offered insights on the importance of strategic alignment of policies, processes, and partnerships. Oregon discussed its home visiting program and quality incentive strategy for its coordinated care organizations. The state incentivizes progress on the HEDIS measures and other measures designed by the state’s Pediatric Improvement Partnership, including a measure of social-emotional health service capacity and access for infants and children. Michigan discussed how they requires MCOs to identify and publish disparities in well-child visit rates and how they encourage plans to reduce disparities. The state also uses an algorithm that automatically assigns members to MCOs based on MCOs’ performance and reimburses for maternal-infant health home visiting. North Carolina shared its Keeping Kids Well program, which aims to increase well-child visit and immunization rates and reduce disparities in those rates. The program offers coaches to practices to support their improvements, established an advisory board of key interested parties, and provides customized vaccination notices for practices to distribute to beneficiaries, in partnership with health systems and pharmaceutical companies. The state also used the Healthy Opportunities payment to incentivize the identification and redress of health-related social needs and provided the Health Equity Payment to providers serving areas with high poverty rates.

i 3 Hagan, J.F., J.S. Shaw, and P.M. Duncan (eds.). Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents. 4th ed. Elk Grove Village, IL: American Academy of Pediatrics, 2017.

ii Gill, J.M., A. Saldarriaga, A.G. Mainous, and D. Unger. “Does Continuity Between Prenatal and Well-Child Care Improve Childhood Immunizations?” Family Medicine, vol. 34, no. 4, April 2002, pp. 274–280.

iii Buchholz, M., and A. Talmi. “What We Talked About at the Pediatrician’s Office: Exploring Differences Between Healthy Steps and Traditional Pediatric Primary Care Visits.” Infant Mental Health Journal, vol. 33, no. 4, 2012, pp. 430–436.

iv DeVoe, J.E., M. Hoopes, C.A. Nelson, et al. “Electronic Health Record Tools to Assist with Children’s Insurance Coverage: A Mixed Methods Study.” BMC Health Services Research, vol.18, no. 1, May 2018, p. 354–360.

v Coker, T.R., S. Chacon, M.N. Elliott, et al. “A Parent Coach Model for Well-Child Care Among Low-Income Children: A Randomized Controlled Trial.” Pediatrics, vol. 137, no. 3, March 2016, p. e20153013.

vi Flores, G., H. Lin, C. Walker, M. Lee, J. Currie, R. Allgeyer, M. Fierro, M. Henry, A. Portillo, and K. Massey. “Parent Mentoring Program Increases Coverage Rates for Uninsured Latino Children.” Health Affairs, vol. 37, no. 3, 2018, pp. 403–412.

vii Hakim, R.B., and D.S. Ronsaville. “Effect of Compliance with Health Supervision Guidelines Among US Infants on Emergency Department Visits.” Archives of Pediatrics & Adolescent Medicine, vol. 156, no. 10, October 2002, pp. 1015–1020.

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Well-Child Visits Help Children Grow Big and Strong

Parents know: a healthy childhood helps put children on the right track for the rest of their lives. That involves things like sparking their curiosity, reading them bedtime stories and begging them to eat more broccoli. That’s only half the battle, however.

You might think you only need to take your child to the doctor when they’re feeling under the weather, but taking them to the doctor even when they’re healthy helps ensure they are growing up big and strong, too.

These visits are called ‘well-child visits,’ and they come at no cost for Service Benefit Plan members when visiting Preferred providers. During a well-child visit, your child’s doctor tracks their growth and asks about their behavior. It’s also the perfect opportunity to ask any questions you may have about your child’s development, like how much sleep they need and when they’ll start to talk.

Well-child visits are also a chance for your child to receive important routine vaccinations that protect their health. After years of study, vaccines are proven:

Very effective at disease prevention
To reduce the risk of hospitalization
To reduce the risk of death in children
Safe with little to no side effects

Vaccinations are strongly recommended by physicians and the Centers for Disease Control (CDC). Click here to see the recommended vaccines for children.

Your child’s first well-child visit should happen when they’re three to five days old and continue until they’re 17 years old. Talk with your child’s doctor about when their next well-child visit should be and what vaccinations they're due for.

Remember that routine vaccinations and preventive care visits come at no cost when visiting Preferred providers. Having a doctor nearby can make keeping your child up to date on their preventive care a breeze. You can use our National Doctor and Hospital Finder tool to find a Preferred provider in your neighborhood.

https://www.healthychildren.org/English/family-life/health-management/Pages/Well-Child-Care-A-Check-Up-for-Success.aspx

https://www.drugs.com/cg/well-child-visits.html

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Preventive Services Covered by Private Health Plans under the Affordable Care Act

Published: Feb 28, 2024

Note: This content was updated on February 28, 2024 to incorporate new FAQs from CMS. Tables 1 and 2 were also updated to include updated recommendations. It has been more than ten years since the Affordable Care Act (ACA) required private insurance plans to cover recommended preventive services without any patient cost-sharing. 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. Since the preventive services coverage policy went into effect, there have been numerous additions, changes, and updates to the policy as well as specific recommendations. There have also been legal challenges over elements of the preventive services requirement, including in the pending case, Braidwood Management Inc. v. Becerra . This fact sheet summarizes the federal requirements for coverage for preventive services in private plans, major updates to the requirement, and recent policy activities on this front.

ACA Requirements for Coverage of Preventive Services

Under Section 2713 of the ACA, private health plans must provide coverage for a range of recommended preventive services and may not impose cost-sharing (such as copayments, deductibles, or co-insurance) on patients receiving these services. 1 These requirements apply to all private plans—fully insured and self-insured plans in the individual, small group, and large group markets, except those that maintain “grandfathered” status. In 2019 , 13% of workers covered in employer sponsored plans were still in grandfathered plans. The requirements also apply to the Medicaid expansion eligibility pathway.

The required preventive services come from recommendations issued by four expert medical and scientific bodies—the U.S. Preventive Services Task Force (USPSTF), the Advisory Committee on Immunization Practices (ACIP), the Health Resources and Services Administration’s (HRSA’s) Bright Futures Project, and the HRSA-sponsored Women’s Preventive Services Initiative (WPSI). Individual and small group plans in the health insurance marketplaces are also required to cover an essential health benefit (EHB) package —that includes the full range of preventive requirements described in this fact sheet.

Clinical Preventive Services for Adults and Children

The ACA requires private plans to cover the following four broad categories of services for adults and children (summarized in Tables 1 and 2 ):

I. Evidence-Based Screenings and Counseling

Insurers must cover evidence-based services for adults that have a rating of “A” or “B” in the current recommendations of USPSTF , an independent panel of clinicians and scientists commissioned by the federal Agency for Healthcare Research and Quality. An “A” or “B” letter grade indicates that the panel finds there is high certainty that the services have a substantial or moderate net health benefit. The services required to be covered without cost-sharing include screenings for depression, diabetes, obesity, various cancers, and sexually transmitted infections (STIs), prenatal tests, medications that can help prevent HIV, breast cancer, and heart disease, as well as counseling for drug and tobacco use, healthy eating, and other common health concerns. The effective date for a new recommendation from USPSTF is considered to be the last day of the month in which it is published or otherwise released.

II. Routine Immunizations

Health plans must also provide coverage without cost-sharing for immunizations that are recommended and determined to be for routine use by the ACIP , a federal committee comprised of immunization experts that is convened by the Centers for Disease Control and Prevention (CDC). A new ACIP recommendation is considered to be issued on the date that it is adopted by the Director of the CDC. The preventive services guidelines require coverage for adults and children and include immunizations such as influenza, meningitis, tetanus, HPV, hepatitis A and B, measles, mumps, rubella, varicella, and COVID-19. With regard to the COVID-19 vaccine, Congress waived the typical one year delay in implementation and required private insurance plans to begin full coverage 15 days after ACIP recommendation. Going forward, any COVID-19 vaccine recommended by ACIP, including updated boosters, will continue to be fully covered for people enrolled in non-grandfathered plans starting 15 days after the vaccine is recommended by ACIP, irrespective of whether the vaccine is under an emergency use authorization or fully approved by the FDA.

III. Preventive Services for Women

In addition to the recommendations issued by USPSTF and ACIP, the ACA authorized HRSA to make coverage requirements for women for services not addressed by the other recommending bodies. HRSA turns to evidence-based recommendations issued by the Women’s Preventive Services Initiative (WPSI), to identify gaps in recommendations for women and review the evidence regarding the effectiveness of the recommendations. Current recommendations include well-woman visits, all FDA-approved, -granted, or -cleared contraceptives and related services, breastfeeding support and supplies, broader screening and counseling for a range of conditions, including intimate partner violence, urinary incontinence, anxiety, STIs and HIV. Some of the HRSA recommendations for women are similar to recommendations from USPSTF, but with slight variations in the population that is addressed.

Table 1 summarizes the full slate of adult preventive services subject to the preventive services coverage requirements.

IV. Preventive Services for Children and Youth

In addition to services for adults, the ACA requires that private plans cover without cost-sharing the preventive services recommended by the HRSA’s Bright Futures Project , which provides evidence-informed recommendations to improve the health and wellbeing of infants, children, and adolescents. The preventive services covered for children and adolescents include well child visits, immunization and screening services, behavioral and developmental assessments, fluoride supplements, and screening for autism, vision impairment, lipid disorders, tuberculosis, and certain genetic diseases. immunization and screening services, behavioral and developmental assessments, fluoride supplements, and screening for autism, vision impairment, lipid disorders, tuberculosis, and certain genetic diseases.

Table 2 summarizes the full slate of preventive services for children and adolescents.

Coverage Rules and Clarifications

The recommending bodies periodically issue new recommendations and update existing ones based on advances in research. Plans are required to provide full coverage for new and updated recommendations one year after the latest issue date, beginning in the next plan year. 2 If a recommendation is changed during a plan year or a new recommendation is issued, an issuer is not required to make changes in the middle of the plan year, unless one of the recommending bodies determines that a service is discouraged because it is harmful or poses a significant safety concern. 3 In these circumstances, federal guidance will be issued. There are limited circumstances under which insurers may charge copayments and use other forms of cost-sharing for preventive services:

If the primary reason for the visit is not the preventive service, patients may have to pay for the office visit. For example, if an adult man sees a clinician for ongoing management of a chronic condition such as diabetes and also receives a COVID vaccine at that appointment, the plan may charge a co-payment for the office visit but may not charge for the vaccine, which is a recommended preventive service.
If the preventive service is performed by an out-of-network provider when an in-network provider is available to perform the service, insurers may charge patients for the office visit and the preventive service. However, if an out-of-network provider is used because there is no in-network provider able to provide the service then cost-sharing cannot be charged.
If a treatment is given as the result of a recommended preventive service, but is not the recommended preventive service itself, cost-sharing may be charged in some cases . For example, the USPSTF recommends a CT scan for some adults to screen for lung cancer. If cancer is detected during the scan, treatments such as surgery or medication may be prescribed. While plans must cover the screening test services in full, they may charge for the treatments.

The Public Health Service Act (PHSA) and federal regulations also allow plans to use “ reasonable medical management ” techniques to determine the frequency, method, treatment, or setting for a preventive item or service to the extent it is not specified in a recommendation or guideline. While there is no formal regulatory definition or parameters for reasonable medical management, medical management techniques are typically used by plans to control cost and utilization of care or comparable drug use. For example, plans can impose limits on number of visits or tests if unspecified by a recommendation, cover only generics or selected brands of pharmaceuticals, or require prior authorization to acquire a preferred brand drug. If a plan makes any material modifications that would affect the content of the plan’s Summary of Benefits and Coverage (SBC) during the plan year, the plan must notify enrollees of the change at least 60 days before it takes effect.

Since the policy took effect, a number of questions have arisen about how plans should implement the preventive services policy and the extent to which plans can use medical management practices to limit the frequency, range of covered services, and the types of providers that are subject to the policy. Over the years, the Departments of Health and Human Services, Labor, and Treasury have jointly issued a number of clarifications as” about different aspects of coverage of preventive services.

Notable highlights from clarifying documents include:

Colon cancer screening – USPSTF recommends screening for colorectal cancer in adults ages 45-75 using either stool-based testing or procedural screening, such as sigmoidoscopy or colonoscopy. There have been some cases of insured asymptomatic patients being charged unexpected cost-sharing for anesthesia and polyp removal during screening colonoscopies . The federal government has clarified multiple times that insurers must cover the full cost of medically necessary anesthesia services, polyp removal and related pathology performed in connection with a preventive colonoscopy in asymptomatic individuals, and follow up colonoscopies in the event of positive findings on stool-based tests, CT, or sigmoidoscopy.
Well-woman visits – The HRSA clinical preventive services for women include coverage for at least one well-woman preventive care visit for adult women. WPSI has clarified that a series of well-woma n visits may be required to fulfill all necessary preventive services and should be provided without cost-sharing as needed, determined by clinical expertise. Furthermore, the most recent recommendation states that prenatal visits are considered well woman visits, as are pre-pregnancy, postpartum, and interpartum visits WPSI has also published recommendations for services to be provided as part of well woman care.
Testing and medications for the risk reduction of breast cancer – Federal guidance reinforces the USPSTF recommendation that women with family history of breast, ovarian, or peritoneal cancer should be screened for BRCA-related cancer, and those with positive results should receive genetic counseling and testing without cost-sharing when the services are medically appropriate and recommended by her provider. USPSTF also recommends the provision of chemo-preventive medications, such as tamoxifen and raloxifene, for women who are at increased risk for breast cancer and at low risk for adverse effects.
Special populations – Some of the recommendations subject to the preventive services requirement apply to a certain population, such as “high risk” individuals. The government has clarified that it is up to the health care provider to determine whether a patient belongs to the population in consideration and that plans must cover services accordingly. An individual’s sex assigned at birth or gender identity also cannot limit them from a recommended preventive service that is medically appropriate for that individual; for example, a transgender man who has breast tissue or an intact cervix and meets other requirements for mammography or cervical cancer screening must receive those services without cost sharing regardless of sex at birth.
Contraceptive coverage – Contraceptive services and supplies for women is one of the recommendations from HRSA, and since it was first issued there have been numerous federal clarifications. Plans must cover without cost sharing at least one product within each FDA-approved, granted, or cleared contraceptive method for women as prescribed. In addition to covering the cost of the contraceptive supplies, plans must cover related counseling, insertion, removal, and follow up services. While insurers may use reasonable medical management to limit full coverage to generic drugs within a method category, federal clarifications also state that plans must cover any contraceptive if deemed “medically necessary” by a health care provider. This means that plans must cover the following: brand name drugs if a generic is not available, a clinician-recommended brand name product, and contraceptive products that are not specifically identified by HRSA, such as new contraceptive products approved by the FDA. Some plans may choose to cover only one product within a category of contraceptives that has other therapeutic equivalent products. If this is the case, the plan must have a process in place to make exceptions for an individual who want s to access a therapeutic equivalent product if it is determined to be medically necessary by the individual’s clinician . Any “exceptions process” must be accessible and timely for patients and providers to request coverage for a medically necessary contraceptive.
Houses of worship have always been exempted from the contraceptive requirement, and religiously affiliated nonprofit employers have had an accommodation if they have a religious objection to contraceptives. Some employers have challenged this regulation, claiming the accommodation offered by the government (where the method is covered by their plan but they are not required to pay towards its coverage as part of the premium) makes them complicit in the provision of contraception, a service they object to on religious or moral grounds. The federal policy regarding contraceptive coverage requirements for employer plans has undergone multiple changes in federal regulations and been contested in numerous legal cases, including three that reached the Supreme Court. The current regulations were issued during the Trump Administration and exempt nearly any employer that claims to have a religious or moral objection from providing contraceptive coverage.
Coverage for HIV Preexposure Prophylaxis (PrEP) – In June 2019, PrEP, medications which can help prevent HIV, received an “A”’ grade recommendation from the USPSTF as “effective antiretroviral therapy to persons who are at high risk of HIV acquisition.” Plans or policy years beginning on or after June 30, 2020, must cover PrEP (consistent with the USPSTF recommendation) without cost sharing. Federal guidance clarified that plans and insurers must also cover ancillary and support services for PrEP, such as adherence counseling and risk-reduction strategies, without cost sharing, and cannot use reasonable medical management techniques to restrict access to these services.

Impact of the Preventive Services Rules

The federal HHS Assistant Secretary for Planning and Evaluation (ASPE) estimates that in 2020, approximately 151.6 million people (58 million women, 57 million men, and 37 million children) currently are enrolled in non-grandfathered private health insurance plans that cover preventive services with no-cost sharing. Research has documented the impact of the policy on access to care in some areas, including utilization of cancer screening and contraceptives.

The evidence on cancer screening utilization after the elimination of cost-sharing is mixed and varies by cancer type. Some studies have shown that while screening rates for colorectal cancer among privately insured individuals increased since the passage of the ACA, rates for Pap testing decreased . However, it is difficult to assess the impact of the coverage provision since the recommendations for cervical cancer screening have been revised since the policy went into effect. Screening rates for breast cancer remained stable, though one study found that mammography screening among African American women significantly increased after ACA implementation. Likewise, the elimination of cost-sharing is associated with increases in BRCA genetic testing which helps identify women who are at elevated risk for breast and ovarian cancer. Studies have also indicated that increased access to and affordability of preventive services has helped cancer survivors obtain necessary care.

Several studies found that the contraceptive coverage requirement under the ACA has dramatically reduced OOP spending for contraceptives, including OOP spending for oral contraceptives (Figure 2). Multiple studies have shown increases in utilization for short-term birth control methods such as birth control pills, patches, and diaphragms. Studies have found that utilization of long-acting reversible contraceptives (LARCs), such as intrauterine devices (IUDs) and implants, increased after ACA implementation. Additional research also shows that OOP costs for LARCs —some of the most effective forms of pregnancy prevention—were also reduced under the ACA. These findings suggest that the lowered OOP costs from the contraceptive coverage requirement has improved contraception use and adherence .

The preventive services coverage policy has become an established part of health coverage for most people in the United States. Yet, the policy is currently facing legal challenges, notably in the case Braidwood Management Inc v. Becerra. The outcome of the latest legal challenge could affect whether people will continue to have full no-cost coverage for recommended preventive services in the future.

Note that the rules described in this fact sheet apply to private insurers, self-insured employer plans, and are separate from preventive requirements for public programs like Medicare or Medicaid.

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The final issue date for new or updated recommendations varies by recommending body. Recommendations are considered to be issued on the last day of the month on which the USPSTF publishes or releases the recommendation; recommendations from ACIP are considered issued on the date it is adopted by the Director of the CDC; and a recommendation or guideline supported by HRSA is considered to be issued on the date on which it is accepted by the Administrator of HRSA or, if applicable, adopted by the Secretary of HHS. Federal Register, Vol. 80, NO. 134, July 14, 2015.

These circumstances include downgrade of a USPSTF service from a rating of “A” or “B” to “D” (which means that USPTF has determined that there is strong evidence that there is no net benefit, or that the harms outweigh the benefits, and therefore discourages the use of this service), or a service is the subject of a safety recall or otherwise determined to pose a significant safety concern by a federal agency authorized to regulate that item or service.

Women's Health Policy
Affordable Care Act
Private Insurance
Cost Sharing

Also of Interest

Preventive Services Tracker
Preventive Services for Women Covered by Private Health Plans under the Affordable Care Act

Family Life

5 reasons why parents might receive a bill after a well-child visit.

By: Suzanne Berman, MD, FAAP & Angelo Peter Giardino, MD, PhD, FAAP

Parents are sometimes surprised when they get a bill from their pediatrician's office for part―or all―of their child's well visit . Sometimes parents are even concerned that their pediatrician has made an error in their bill.

While any billing office should be happy to review its records for errors, the following are common reasons you might receive a bill after a well-child visit:

Reason 1: Your child's insurance plan is not ACA-compliant .

While new group health plans and exchange plans are required to cover all parts of the well child visit with no cost sharing, many health insurance plans are exempt from the ACA and, as a result, this requirement. These include existing unchanged health plans from before the ACA became law ("grandfathered" plans), federal employee plans, government plans like Tricare or ChampVA, ERISA-based self-insured plans, and membership plans like faith-based cost-sharing services.

Reason 2: Your child's insurance plan is ACA-compliant, but you received some preventive services which are not part of the ACA-recommended list .

The list of services that ACA-compliant plans are expected to cover can be found at the US Preventive Services Task Force . For example, routine vaccines ―not travel vaccines ―are in the list of covered preventive services. If a child received a travel vaccine as part of a well-child visit, an ACA-compliant plan may not full cover the cost of the travel vaccine (even though it is a preventive service).

Reason 3. Your child's insurance plan is ACA-compliant, but you received some non-preventive services as part of the visit .

Examples might include lung function testing for asthma or evaluation of chronic headaches done at a well-child visit. While both of these services help promote wellness, neither are included in the definition of a standard well-child visit service and may result in an additional charge based on the rules of your insurance plan. Some families only want covered preventive services at a well child visit; other families appreciate that a pediatrician can provide all needed services at the same time so you don't have to come back for a separate visit. Ask your pediatrician's practice about its policy regarding providing sick and well child visit services on the same date.

Reason 4. Your child's insurance plan is ACA-compliant, but you received more frequent services than is typical .

This occurs when well-child visits are scheduled closer together than what the insurance company considers to be "annual." Some insurance companies pay for one well child visit per calendar year. This means a child might have a check-up in September one year and July the next. Other insurance companies have more stringent rules and say that at least 365 days must pass between well exams. If not, the second well visit will be denied by your insurance company, and you will be responsible for the charge. Be sure you understand your insurance company's definition of "annual" before scheduling the appointment.

Reason 5. You received ACA preventive services, but your insurance company does not recognize the billing code(s) your pediatrician use for that service .

For example, vision screening for children ages 3 to 5 is an ACA preventive service. In 2017, there are three codes that are commonly used to report vision screening in children: simple eyechart and two types of electronic instruments.

Some insurance plans recognize the eyechart code as an ACA code, but not the electronic instrument code. In that case, a family would have no cost-sharing responsibility for an eye chart, but they would if their child could not use an eye chart, and the pediatrician screened vision using an electronic instrument. Families might understandably ask the pediatrician's office to use the covered code―even if the pediatrician used the other method. However, it is a violation of insurance contracts and federal and state laws to knowingly report the wrong code.

Other insurance plans might permit all the vision screening codes as ACA preventive, but not accept them when billed by a pediatrician. The plan only pays for them when the family makes a separate trip to an eye doctor.

The American Academy of Pediatrics (AAP) is constantly working with insurance plans to educate them on pediatric-specific codes. Learn more about this here .

Additional Information:

AAP Schedule of Well-Child Care Visits

Understanding Cost Sharing: Deductibles, Copayments & Coinsurance

FAQs: Preferred & Out-of-Network Providers

About Dr. Berman:

About Dr. Giardino:

Financial Tips, Guides & Know-Hows

Home > Finance > How Much Does A Pediatrician Visit Cost Without Insurance

How Much Does A Pediatrician Visit Cost Without Insurance

Published: November 23, 2023

Without insurance, the cost of a pediatrician visit can vary. Learn about the different factors that can impact the price and find ways to manage your finances effectively.

(Many of the links in this article redirect to a specific reviewed product. Your purchase of these products through affiliate links helps to generate commission for LiveWell, at no extra cost. Learn more )

Introduction, understanding pediatrician visits, factors affecting the cost of pediatrician visits, average cost of pediatrician visits without insurance, ways to reduce the cost of pediatrician visits without insurance, free and low-cost options for pediatrician visits.

When it comes to taking care of our children’s health, regular visits to a pediatrician are crucial. However, not everyone has the luxury of health insurance coverage to offset the costs associated with these visits. That’s why it’s essential to understand how much a pediatrician visit may cost without insurance.

A pediatrician is a specialized doctor who provides medical care for infants, children, and adolescents. These visits involve routine check-ups, immunizations, developmental assessments, and addressing any concerns parents may have about their child’s health. While the primary focus is on the well-being of the child, the financial aspect cannot be overlooked.

The cost of a pediatrician visit without insurance can vary significantly depending on various factors such as the location, services provided, and the specific needs of the patient. Understanding these factors can help parents better navigate the financial aspect of pediatrician visits and plan accordingly.

In this article, we will delve into the factors that influence the cost of pediatrician visits without insurance, explore the average costs, and discuss ways to reduce the financial burden. We will also touch on free and low-cost options available for families facing financial constraints.

It’s important to note that while this article provides general information, the actual costs can vary, and it is always advisable to consult with a pediatrician or healthcare provider for accurate and up-to-date information.

Now, let’s dive deeper into the world of pediatrician visits and understand how much they may cost without insurance coverage.

Pediatrician visits are an essential aspect of a child’s healthcare journey. These visits serve several purposes, including preventive care, assessing growth and development, addressing health concerns, and providing necessary vaccinations. By understanding the different aspects of pediatrician visits, parents can ensure their child receives comprehensive healthcare.

Preventive care is a key component of pediatrician visits. Regular check-ups, often referred to as well-child visits, are scheduled at various intervals, starting from infancy and continuing through adolescence. These visits allow the pediatrician to monitor the child’s growth and development, assess their overall health status, conduct routine screenings, and provide guidance on nutrition, safety, and age-appropriate activities.

During pediatrician visits, developmental assessments are conducted to track the child’s milestones, such as cognitive, motor, and social-emotional development. This enables the pediatrician to identify any potential delays or concerns and provide appropriate interventions or referrals to specialists if necessary.

Immunizations are another important aspect of pediatrician visits. These vaccinations protect children against various diseases and help maintain community immunity. The pediatrician will administer vaccines according to the recommended schedule, ensuring that the child is up to date with the necessary immunizations.

In addition to preventive care, pediatrician visits address any health concerns or issues that parents may have about their child’s physical or emotional well-being. This can include acute illnesses, chronic conditions, allergies, behavioral concerns, or any other medical issues that may arise. The pediatrician will conduct examinations, order tests if needed, and provide appropriate treatment or referrals to specialists.

Overall, pediatrician visits play a vital role in promoting and maintaining children’s health and well-being. By establishing a strong relationship with a pediatrician, parents can ensure that their child receives comprehensive medical care, guidance, and support throughout their development.

In the next section, we will explore the factors that can influence the cost of pediatrician visits without insurance.

The cost of pediatrician visits without insurance can vary depending on several factors. Understanding these factors can help parents anticipate and plan for the expenses associated with their child’s medical care. Here are some key factors that can influence the cost of pediatrician visits:

Location: The geographical location plays a significant role in determining the cost of pediatrician visits. In areas with a higher cost of living, such as major cities, the fees may be higher compared to smaller towns or rural areas. It’s important to research and compare the rates of pediatricians in your specific location to get an idea of the expected costs.
Type of Visit: The purpose of the visit can also affect the cost. Routine well-child visits, which include preventive care and developmental assessments, may have a different price range compared to visits for acute illnesses or specialized consultations. The complexity and duration of the visit can impact the overall cost.
Services Provided: Pediatrician visits may encompass a range of services, from physical examinations and vaccinations to laboratory tests and screenings. The cost may differ depending on the specific services provided during the visit. For example, additional tests or procedures may incur extra charges.
Additional Services: In some cases, pediatricians may offer additional services or procedures not covered by insurance, such as certain types of counseling or specialized treatments. These services may come at an additional cost, so it’s important to discuss and understand what is included in the visit and any potential extra charges.
Experience and Reputation: Pediatricians with extensive experience and a strong reputation in their field may charge higher fees for their services. The level of expertise and recognition can impact the cost of pediatrician visits. However, it’s essential to consider the quality of care and the relationship with the pediatrician when evaluating the value of their services.

It’s important to note that these factors are not exhaustive, and the cost of pediatrician visits can vary from practice to practice. The best way to determine the specific cost of pediatrician visits without insurance is to contact the pediatrician’s office directly and inquire about their fees and any additional expenses that may be incurred.

Now that we understand the factors influencing the cost of pediatrician visits, let’s explore the average costs parents can expect to encounter without insurance coverage in the next section.

While the cost of pediatrician visits without insurance can vary, it’s helpful to have a general understanding of the average expenses you may encounter. Keep in mind that these numbers are approximate and can differ based on the factors discussed earlier.

A routine well-child visit, which includes a comprehensive examination, developmental assessment, and immunizations, can cost anywhere from $100 to $300 without insurance. The cost may be higher for initial visits or visits that involve additional screenings or specialized consultations.

Visits for acute illnesses or specific concerns may have different price ranges. For example, a visit to address a common illness like the flu or a minor injury may range from $75 to $150 without insurance. However, if the visit requires additional tests or treatments, the cost can increase accordingly.

It’s important to note that these costs are for the pediatrician’s services only and do not include any additional costs such as laboratory tests, X-rays, or medications. These additional expenses can further contribute to the overall cost of the visit.

It’s worth mentioning that some pediatricians offer discounted rates or payment plans for uninsured patients, so it’s helpful to inquire about any available options when scheduling an appointment. Additionally, some practices may have a sliding fee scale based on income for families who meet specific criteria.

Now that we have a general idea of the average costs, let’s explore some strategies to help reduce the financial burden of pediatrician visits without insurance in the next section.

While the cost of pediatrician visits without insurance can be a financial burden, there are several strategies that parents can employ to help reduce these expenses. Here are some ways to mitigate the costs and make pediatrician visits more affordable:

Shop around: Research and compare the rates of different pediatricians in your area. Look for practices that offer competitive pricing without compromising the quality of care. Additionally, inquire about any discounts or payment plans that may be available for uninsured patients.
Consider telemedicine: Telemedicine services have gained popularity in recent years, allowing remote consultations with healthcare providers. Some pediatricians offer virtual visits, which can be a more cost-effective option compared to in-person visits. This can be particularly useful for minor illnesses or follow-up consultations.
Utilize community health clinics: Community health clinics often provide low-cost or free pediatric services to families in need. These clinics may offer comprehensive well-child visits, vaccinations, and basic medical care at reduced rates. Research local community clinics in your area and determine if you qualify for their services.
Explore government assistance programs: Depending on your income level and eligibility criteria, you may qualify for government assistance programs that provide healthcare coverage for children. Programs such as Medicaid or the Children’s Health Insurance Program (CHIP) can help offset the costs of pediatrician visits and other medical expenses. Check if you meet the requirements to enroll in these programs.
Ask for itemized billing: When receiving the bill for a pediatrician visit, ask for an itemized breakdown of the charges. This will help you understand the specific services provided and allow you to identify any potential errors or unnecessary charges that can be addressed.
Negotiate payment plans: If you are facing financial limitations, communicate with your pediatrician’s office and explore the option of setting up a payment plan. Many healthcare providers are willing to work with patients to establish affordable payment arrangements over time.
Consider healthcare savings accounts: Healthcare savings accounts, such as Health Savings Accounts (HSAs) or Flexible Spending Accounts (FSAs), allow you to set aside pre-tax money specifically for medical expenses. By utilizing these accounts, you can allocate funds for pediatrician visits and reduce the financial burden.

It’s important to proactively communicate with your pediatrician and be open about your financial situation. They may have additional resources or recommendations to help you navigate the cost of pediatrician visits.

Now, let’s explore some free and low-cost options available for families facing financial constraints.

Families facing financial constraints can still access pediatrician visits through various free and low-cost options. These resources ensure that children receive the necessary medical care regardless of their financial situation. Here are some options to consider:

Community health clinics: As mentioned earlier, community health clinics often provide pediatric services at reduced rates or even for free. These clinics prioritize serving low-income individuals and families and offer comprehensive healthcare, including well-child visits, vaccinations, and basic medical care. Contact local clinics or use online directories to find community health centers in your area.
School-based health centers: Many schools have health centers on their premises that offer medical services to students. These centers often have pediatricians or nurse practitioners available to provide healthcare, including routine check-ups and evaluations. If your child attends a school with a health center, it can be a convenient and affordable option for pediatrician visits.
Government assistance programs: Government programs, such as Medicaid or the Children’s Health Insurance Program (CHIP), provide healthcare coverage for eligible children from low-income families. These programs offer comprehensive medical services, including pediatrician visits, at little to no cost. Check if you meet the criteria to enroll your child in these programs and access the benefits they provide.
Non-profit organizations: Some non-profit organizations and charities focus on improving access to healthcare for children in need. They may offer free or low-cost pediatrician visits or collaborate with healthcare providers to provide subsidized services. Research local non-profit organizations that focus on children’s healthcare and inquire about their available resources.
Teaching hospitals and medical schools: Teaching hospitals and medical schools often provide pediatric services at reduced rates. These institutions train medical students, residents, and fellows, who can offer care under the supervision of experienced physicians. While the cost is typically lower in these settings, the quality of care remains high. Contact teaching hospitals or medical schools in your area to inquire about their pediatric services.
Wellness programs and health fairs: Many communities organize wellness programs and health fairs that include free or low-cost healthcare services, including pediatrician visits. These events often collaborate with healthcare providers to offer medical check-ups, vaccinations, and health education. Stay informed about such programs in your community and take advantage of the available services.

Remember to research and reach out to these resources in advance to determine their availability, eligibility criteria, and any necessary documentation you may need to bring with you. These options can help ensure that your child receives the medical care they need without placing a significant financial burden on your family.

Now, let’s conclude our discussion on the cost of pediatrician visits without insurance.

Regular pediatrician visits are essential for the health and well-being of children, but the cost can be a concern for families without insurance coverage. Understanding the factors that influence the cost of pediatrician visits, such as location, type of visit, and services provided, can help parents anticipate expenses and plan accordingly.

The average cost of pediatrician visits without insurance can range from $100 to $300 for routine well-child visits, while visits for acute illnesses or specialized consultations may have different price ranges. It’s important to keep in mind that additional costs for laboratory tests, medications, and procedures can further contribute to the overall expenses.

There are several ways to reduce the cost of pediatrician visits without insurance. Shopping around, considering telemedicine, utilizing community health clinics, exploring government assistance programs, and negotiating payment plans are all strategies that can help alleviate the financial burden. Additionally, healthcare savings accounts can provide a means to set aside funds specifically for medical expenses.

For families facing financial constraints, free and low-cost options are available to access pediatrician visits. Community health clinics, school-based health centers, government assistance programs, non-profit organizations, teaching hospitals, and wellness programs can provide pediatric services at reduced rates or even for free.

While this article provides general information, it’s important to consult with a pediatrician or healthcare provider to get accurate and up-to-date cost details for pediatrician visits without insurance. They can provide personalized information based on your specific situation.

Remember, the well-being of your child should be a top priority, and there are resources available to ensure they receive the necessary medical care, even without insurance coverage. By taking proactive steps to manage the costs, you can provide your child with the healthcare they need while minimizing the financial impact on your family.

Now that you have a better understanding of the cost considerations and available options, you can approach pediatrician visits with confidence, knowing that there are ways to make it more manageable for your family.

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Catch Up on Well-Child Visits and Recommended Vaccinations

A happy child in a lion custome. Text: Let's play catch-up on routine vaccines

Many children missed check-ups and recommended childhood vaccinations over the past few years. CDC and the American Academy of Pediatrics (AAP) recommend children catch up on routine childhood vaccinations and get back on track for school, childcare, and beyond.

Making sure that your child sees their doctor for well-child visits and recommended vaccines is one of the best things you can do to protect your child and community from serious diseases that are easily spread.

Well-Child Visits and Recommended Vaccinations Are Essential

Doctor treating girl, mother holds child

Well-child visits and recommended vaccinations are essential and help make sure children stay healthy. Children who are not protected by vaccines are more likely to get diseases like measles and whooping cough . These diseases are extremely contagious and can be very serious, especially for babies and young children. In recent years, there have been outbreaks of these diseases, especially in communities with low vaccination rates.

Well-child visits are essential for many reasons , including:

Tracking growth and developmental milestones
Discussing any concerns about your child’s health
Getting scheduled vaccinations to prevent illnesses like measles and whooping cough (pertussis) and other serious diseases

sisters laughing and running with toy airplane

It’s particularly important for parents to work with their child’s doctor or nurse to make sure they get caught up on missed well-child visits and recommended vaccines.

Routinely Recommended Vaccines for Children and Adolescents

Getting children and adolescents caught up with recommended vaccinations is the best way to protect them from a variety of vaccine-preventable diseases . The schedules below outline the vaccines recommended for each age group.

See which vaccines your child needs from birth through age 6 in this easy-to-read immunization schedule.

See which vaccines your child needs from ages 7 through 18 in this easy-to-read immunization schedule.

The Vaccines for Children (VFC) program provides vaccines to eligible children at no cost. This program provides free vaccines to children who are Medicaid-eligible, uninsured, underinsured, or American Indian/Alaska Native. Check out the program’s requirements and talk to your child’s doctor or nurse to see if they are a VFC provider. You can also find a VFC provider by calling your state or local health department or seeing if your state has a VFC website.

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COVID-19 Vaccines for Children and Teens

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Contextual Considerations When Interpreting Well-Child Visit Adherence Results JAMA Pediatrics Comment & Response January 1, 2023 Sarah L. Goff, MD, PhD

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Abdus S , Selden TM. Well-Child Visit Adherence. JAMA Pediatr. 2022;176(11):1143–1145. doi:10.1001/jamapediatrics.2022.2954

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Well-Child Visit Adherence

1 Center for Financing, Access, and Cost Trends, Division of Research and Modeling, Department of Health and Human Services, Agency for Healthcare Research and Quality, Rockville, Maryland
Comment & Response Contextual Considerations When Interpreting Well-Child Visit Adherence Results Sarah L. Goff, MD, PhD JAMA Pediatrics

Well-child care, as recommended by the American Academy of Pediatrics’ Bright Futures guidelines, 1 provides children with preventive and developmental services, helps ensure timely immunizations, and allows parents to discuss health-related concerns. 2 We know from prior studies 3 , 4 that as of 2008, well-child visits were trending upward, but often fell short of recommendations among key socioeconomic groups. This article provides updated evidence on well-child visit adherence, both overall and by age, race and ethnicity, insurance coverage, family income, parent education, urbanicity, and region.

We used the Medical Expenditure Panel Survey (MEPS) 5 to conduct a cross-sectional study of children aged 0 to 18 years in 2006 and 2007 (n = 19 018) and 2016 and 2017 (n = 17 533). Sponsored by the Agency for Healthcare Research and Quality (AHRQ), MEPS provides nationally representative data on child office visits, thereby avoiding potential over reporting from questions more directly about adherence. 3 , 4 Unlike administrative or insurer data, MEPS includes uninsured children and offers extensive socioeconomic information on children and their families.

We defined adherence as the ratio of reported well-child visits during the calendar year divided by the recommended number of visits. Recommendations published in late 2007 added visits at 30 months, 7 years, and 9 years. 1 We used these recommendations throughout our study to maintain consistent adherence denominators. We compared adherence in 2006 and 2007 and 2016 and 2017 for all children and by subgroup (differences-in-differences). This study was covered under the Chesapeake Institutional Review Board protocol for AHRQ Secondary Analysis of Confidential Data from the MEPS, and followed the Strengthening the Reporting of Observational Studies in Epidemiology ( STROBE ) reporting guidelines. The eMethods in the Supplement provide additional methodological details.

Average adherence increased from 47.9% (95% CI, 46.1%-49.7%) in 2006 and 2007 to 62.3% (95% CI, 60.1%-64.6%) in 2016 and 2017, respectively ( Table ), yet large gaps remained across race and ethnicity, poverty level, insurance, and geography. Adherence grew by 17.5 percentage points (95% CI, 11.6%-23.4%) among children ages 7 to 10 years, the group with the largest guideline increase. This increase was not, however, significantly different from adherence growth in either (1) our reference group (ages 4-6 years), selected for having unchanged guidelines and the highest initial adherence, or (2) older children, whose guidelines also remained constant.

Adherence grew unevenly across race and ethnicity, rising by 21.7 percentage points (95% CI, 17.9%-25.5%) among Hispanic children vs 15.3 percentage points (95% CI, 10.9%-19.7%) among White non-Hispanic children. Nevertheless, adherence in 2016 and 2017 among Hispanic children at 58.0% (95% CI, 55.0%-60.9%) still trailed that of White non-Hispanic children at 67.8% (95% CI, 64.3%-71.4%). Adherence among Black non-Hispanic children increased by only 5.6 percentage points (95% CI, 0.3%-11.0%), widening the Black-White adherence disparity among non-Hispanic children.

Adherence also grew unevenly across insurance status, increasing among publicly insured and privately insured children by 15.5 percentage points (95% CI, 11.8%-19.2%) and 13.9 percentage points (95% CI, 10.2%-17.6%), respectively, while not changing significantly among uninsured children. The resulting 2016 and 2017 adherence ratios for children with any private, any public (and no private), and no coverage were 66.3% (95% CI, 63.4%-69.1%), 58.7% (95% CI, 55.7%-61.7%), and 31.1% (95% CI, 23.9%-38.3%), respectively.

We found evidence of increased well-child visit adherence over our study period, which spanned increased visit recommendations, substantial macroeconomic change, and enactment of the Affordable Care Act’s coverage and preventive care provisions. Nevertheless, disturbing gaps remained. Adherence among uninsured children in 2016 and 2017 was only half the national average, and over a 20–percentage point difference still separated the highest-adherence and lowest-adherence regions. The Black non-Hispanic vs White non-Hispanic disparity widened during this period. Narrowing disparities and improving adherence among US children will require the combined efforts of researchers, policy makers, and clinicians to improve our understanding of adherence, to implement policies improving access to care, and to increase health care professional engagement with disadvantaged communities. 6

Accepted for Publication: June 22, 2022.

Published Online: August 22, 2022. doi:10.1001/jamapediatrics.2022.2954

Corresponding Author : Salam Abdus, PhD, Center for Financing, Access, and Cost Trends, Division of Research and Modeling, Department of Health and Human Services, Agency for Healthcare Research and Quality, 5600 Fishers Ln, Rockville, MD 20857 ( [email protected] ).

Author Contributions : Drs Abdus and Selden had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: All authors.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: All authors.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: All authors.

Conflict of Interest Disclosures: None reported.

Disclaimer: The findings and conclusions in this article are those of the authors and do not necessarily represent the views of the US Department of Health and Human Services or the Agency for Healthcare Research and Quality.

Additional Contributions: Joel Cohen, PhD, Yao Ding, PhD, and G. Edward Miller, PhD, of the Agency for Healthcare Research and Quality, provided comments on early versions of the article. and the contributors received no compensation.

Additional Information : This study was conducted by Drs Abdus and Selden as employees of the Agency for Healthcare Research and Quality (AHRQ) and as part of AHRQ’s intramural research program. AHRQ was involved with the internal peer review process.

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Well-child visits.

It's important for your child to have regularly scheduled checkups, often called well-child visits, beginning shortly after birth and lasting through the teen years.

These appointments allow your doctor to keep a close eye on your child's general health and development. Finding possible problems early gives your child the best chance for proper and successful treatment. Also, any concerns you have about your child can be discussed during these visits.

During these visits, the doctor examines your child and asks you questions about your child's development and behavior. Immunizations also are either given or scheduled at this time.

Your child's doctor will recommend a schedule for well-child visits. One example is for visits at ages: footnote 1

3 to 5 days old.
By 1 month.

After age 3, well-child visits are usually scheduled yearly through the teen years.

Citations Bright Futures/American Academy of Pediatrics (2020). Recommendations for preventive pediatric health care. American Academy of Pediatrics . https://downloads.aap.org/AAP/PDF/periodicity_schedule.pdf. Accessed February 27, 2020.

Current as of: October 24, 2023

Author: Healthwise Staff

Clinical Review Board All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.

This information does not replace the advice of a doctor. Healthwise, Incorporated, disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use . Learn how we develop our content .

To learn more about Healthwise, visit Healthwise.org .

$2,000 a month childcare costs are driving moms without college degrees out of the workforce: ‘I really didn’t want to quit’

After a series of lower-paying jobs, Nicole Slemp finally landed one she loved. She was a secretary for Washington’s child services department, a job that came with her own cubicle, and she had a knack for working with families in difficult situations.

Slemp expected to return to work after having her son in August. But then she and her husband started looking for child care – and doing the math. The best option would cost about $2,000 a month, with a long wait list, and even the least expensive option around $1,600, still eating up most of Slemp’s salary. Her husband earns about $35 an hour at a hose distribution company. Between them, they earned too much to qualify for government help.

“I really didn’t want to quit my job,” says Slemp, 33, who lives in a Seattle suburb. But, she says, she felt like she had no choice.

The dilemma is common in the United States, where high-quality child care programs are prohibitively expensive, government assistance is limited , and daycare openings are sometimes hard to find at all. In 2022, more than 1 in 10 young children had a parent who had to quit, turn down or drastically change a job in the previous year because of child care problems. And that burden falls most on mothers, who shoulder more child-rearing responsibilities and are far more likely to leave a job to care for kids .

Even so, women’s participation in the workforce has recovered from the pandemic , reaching historic highs in December 2023. But that masks a lingering crisis among women like Slemp who lack a college degree: The gap in employment rates between mothers who have a four-year degree and those who don’t has only grown.

For mothers without college degrees, a day without work is often a day without pay. They are less likely to have paid leave . And when they face an interruption in child care arrangements, an adult in the family is far more likely to take unpaid time off or to be forced to leave a job altogether, according to an analysis of Census survey data by The Associated Press in partnership with the Education Reporting Collaborative.

In interviews, mothers across the country shared how the seemingly endless search for child care, and its expense, left them feeling defeated. It pushed them off career tracks, robbed them of a sense of purpose, and put them in financial distress.

Women like Slemp challenge the image of the stay-at-home mom as an affluent woman with a high-earning partner, said Jessica Calarco, a sociologist at the University of Wisconsin-Madison.

“The stay-at-home moms in this country are disproportionately mothers who’ve been pushed out of the workforce because they don’t make enough to make it work financially to pay for child care,” Calarco said.

Her own research indicates three-quarters of stay-at-home moms live in households with incomes less than $50,000, and half have household incomes of less than $25,000.

Still, the high cost of child care has upended the careers of even those with college degrees.

When Jane Roberts gave birth in November, she and her husband, both teachers, quickly realized sending baby Dennis to day care was out of the question. It was too costly, and they worried about finding a quality provider in their hometown of Pocatello, Idaho.

The school district has no paid medical or parental leave , so Roberts exhausted her sick leave and personal days to stay home with Dennis. In March, she returned to work and husband Mike took leave. By the end of the school year, they’ll have missed out on a combined nine weeks of pay. To make ends meet, they’ve borrowed money against Jane’s life insurance policy.

In the fall, Roberts won’t return to teaching. The decision was wrenching. “I’ve devoted my entire adult life to this profession,” she said.

For low- and middle-income women who do find child care, the expense can become overwhelming. The Department of Health and Human Services has defined “affordable” child care as an arrangement that costs no more than 7% of a household budget. But a Labor Department study found fewer than 50 American counties where a family earning the median household income could obtain child care at an “ affordable ” price.

There’s also a connection between the cost of child care and the number of mothers working: a 10% increase in the median price of child care was associated with a 1% drop in the maternal workforce , the Labor Department found.

In Birmingham, Alabama, single mother Adriane Burnett takes home about $2,800 a month as a customer service representative for a manufacturing company. She spends more than a third of that on care for her 3-year-old.

In October, that child aged out of a program that qualified the family of three for child care subsidies. So she took on more work, delivering food for DoorDash and Uber Eats. To make the deliveries possible, her 14-year-old has to babysit.

Even so, Burnett had to file for bankruptcy and forfeit her car because she was behind on payments. She is borrowing her father’s car to continue her delivery gigs. The financial stress and guilt over missing time with her kids have affected her health, Burnett said. She has had panic attacks and has fainted at work.

“My kids need me,” Burnett said, “but I also have to work.”

Even for parents who can afford child care, searching for it — and paying for it — consumes reams of time and energy.

When Daizha Rioland was five months pregnant with her first child, she posted in a Facebook group for Dallas moms that she was looking for child care. Several warned she was already behind if she wasn’t on any wait lists. Rioland, who has a bachelor’s degree and works in communications for a nonprofit, wanted a racially diverse program with a strong curriculum.

While her daughter remained on wait lists, Rioland’s parents stepped in to care for her. Finally, her daughter reached the top of a waiting list — at 18 months old. The tuition was so high she could only attend part-time. Rioland got her second daughter on waiting lists long before she was born, and she now attends a center Rioland trusts.

“I’ve grown up in Dallas. I see what happens when you’re not afforded the luxury of high-quality education,” said Rioland, who is Black. “For my daughters, that’s not going to be the case.”

Slemp still sometimes wonders how she ended up staying at home with her son – time she cherishes but also finds disorienting. She thought she was doing well. After stints at a water park and a call center, her state job seemed like a step toward financial stability. How could it be so hard to maintain her career, when everything seemed to be going right?

“Our country is doing nothing to try to help fill that gap ,” Slemp said. As a parent, “we’re supposed to keep the population going, and they’re not giving us a chance to provide for our kids to be able to do that.”

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IMAGES

Importance of Well Child Visits During COVID-19
Your Guide to Well-Child Visits: What To Expect and How To Prepare
AAP Schedule of Well-Child Care Visits
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COMMENTS

Preventive care benefits for children
Sexually transmitted infection (STI) prevention counseling and screening for adolescents at higher risk. Tuberculin testing for children at higher risk of tuberculosis: Age 0 to 11 months , 1 to 4 years , 5 to 10 years , 11 to 14 years , 15 to 17 years. Vision screening for all children. Well-baby and well-child visits.
Well-Child Visit: What's Included and When to Go
The Affordable Care Act requires insurance plans to cover well-child visits - without requiring a copay or coinsurance, even if you haven't met your deductible for the year. This means there are ...
Child Health Insurance Coverage: Screening, Vaccines, & More
Vision: Screening happens at every wellness visit. Your child will get a more complete eye exam around age 3 or 4. Hearing: Screening recommendations vary, so ask your doctor if there will be an ...
AAP Schedule of Well-Child Care Visits
The Bright Futures/American Academy of Pediatrics (AAP) developed a set of comprehensive health guidelines for well-child care, known as the "periodicity schedule." It is a schedule of screenings and assessments recommended at each well-child visit from infancy through adolescence. Schedule of well-child visits. The first week visit (3 to 5 ...
Make the Most of Your Child's Visit to the Doctor (Ages 5 to 10
A well-child visit is when you take your child to the doctor to make sure they're healthy and developing normally. This is different from other visits for sickness or injury. At a well-child visit, the doctor or nurse can help catch any problems early, when they may be easier to treat. You'll also have a chance to ask any questions you may ...
Your Child's Well Visit: What Parents Need to Know
In the world of pediatric care, a well visit is the equivalent of what used to be called a check-up or a physical. Once a year, parents typically make an appointment for a well visit with their family physician or pediatrician to make sure all's well with their child and to voice any concerns. For children 3 and under, though, visits are as frequent as every few weeks in the
Preventive Health Care Visits in Children
Screening. Preventive visits should include a check of vision and hearing. Vision screening may begin at 3 years of age, if children are cooperative, but is recommended at 4 and 5 years of age. Parents should let the doctor know before then if they have any concerns about their child's vision. At this age, vision tests include the use of charts ...
Your Stage-by-Stage Guide to Well-Child Visits
Make sure you have plenty of time before and after their checkup to avoid any stress. Write down questions or concerns as soon as they come to mind before your kid's well-child visit to ensure they get the proper care. Prepare for common questions covering your kid's mental and physical health. Verify your insurance coverage and get a price ...
Make the Most of Your Teen's Visit to the Doctor (Ages 15 to 17
Overview. Teens ages 15 to 17 years need to go to the doctor or nurse for a "well-child visit" once a year. A well-child visit is when you take your teen to the doctor to make sure they're healthy and developing normally. This is different from other visits for sickness or injury. At a well-child visit, the doctor or nurse can help catch ...
Child well visits, birth to 15 months
If you are a UnitedHealthcare Community Plan member, you may have access to our Healthy First Steps program, which can help you find a care provider, schedule well-child visits, connect with educational and community resources and more. To get started, call 1-800-599-5985, TTY 711, Monday through Friday, from 8 a.m. to 5 p.m.
The Impact of the Pandemic on Well-Child Visits for Children ...
More than half (54%) of children under age 21 enrolled in Medicaid or CHIP received a well-child visit in 2019, but the share fell to 48% in 2020, the start of the COVID-19 pandemic. Despite ...
Well-Child Visits for Infants and Young Children
The well-child visit allows for comprehensive assessment of a child and the opportunity for further evaluation if abnormalities are detected. A complete history during the well-child visit ...
Well-Child Care
Beginning in 2021, CMS facilitated the two year Infant Well-Child Visit learning collaborative to support state Medicaid and CHIP agencies' efforts to improve the use of infant well-child visits from 0-15 months of age. The learning collaborative included a webinar series and an affinity group to support state Medicaid and agencies' quality ...
What Does the Children's Health Insurance Program (CHIP) Do?
CHIP is not entirely free, but the cost is modest. States that have Medicaid-expansion CHIP programs abide by Medicaid's rules on premiums and cost-sharing. Some CHIP benefits, such as well-child doctor visits and dental visits, are free. However, your state may charge a copayment for certain services depending on your income.
Well-Child Visits Help Children Grow Big and Strong
Well-child visits are also a chance for your child to receive important routine vaccinations that protect their health. After years of study, vaccines are proven: Very effective at disease prevention. To reduce the risk of hospitalization. To reduce the risk of death in children. Safe with little to no side effects.
Preventive Services Covered by Private Health Plans under the ...
The preventive services covered for children and adolescents include well child visits, immunization and screening services, behavioral and developmental assessments, fluoride supplements, and ...
5 Reasons Why Parents Might Receive a Bill After a Well-Child Visit
Reason 1: Your child's insurance plan is not ACA-compliant. While new group health plans and exchange plans are required to cover all parts of the well child visit with no cost sharing, many health insurance plans are exempt from the ACA and, as a result, this requirement. These include existing unchanged health plans from before the ACA became ...
How Much Does A Pediatrician Visit Cost Without Insurance
A routine well-child visit, which includes a comprehensive examination, developmental assessment, and immunizations, can cost anywhere from $100 to $300 without insurance. The cost may be higher for initial visits or visits that involve additional screenings or specialized consultations.
Well-Child Visits and Recommended Vaccinations
The Vaccines for Children (VFC) program provides vaccines to eligible children at no cost. This program provides free vaccines to children who are Medicaid-eligible, uninsured, underinsured, or American Indian/Alaska Native. Check out the program's requirements and talk to your child's doctor or nurse to see if they are a VFC provider.
Well-Child Visit Adherence
Without knowing more about the insurance plan you mentioned and the services it covers, it is not possible to explain why well-child care might not be covered in this instance. ... Note also that families may receive bills for well-child visits they might have expected to receive for free, as a result of services being provided during the visit ...
Well-Child Visits
During these visits, the doctor examines your child and asks you questions about your child's development and behavior. Immunizations also are either given or scheduled at this time. Your child's doctor will recommend a schedule for well-child visits. One example is for visits at ages: footnote 1. 3 to 5 days old. By 1 month. 2 months. 4 months.
Child and Adolescent Well-Care Visits
Insured children, adolescents, and young adults ages 0 through 20 in Washington get a free health checkup every year! If you need help finding a clinic near you or have trouble scheduling a visit, call your insurance company. If you need help finding coverage, go to wahealthplanfinder.org or call 1-855-923-4633.
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