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Scope of Health Care Benefits for Newborns, Infants, Children, Adolescents and Young Adults Through Age 21 Years

The full test of this policy statement including references will appear in an upcoming issue of Pediatrics.

All newborns, infants, children, adolescents, young adult patients through age 21 years, and pregnant women must have access to comprehensive health care benefits that will ensure their optimal health and well-being. The following services should be included in the health benefit plans offered by all private and public insurers. These services should be delivered by appropriately trained and board eligible/certified pediatric providers, including primary care pediatricians, pediatric medical subspecialists, and pediatric surgical specialists. All providers of prenatal care should be able to identify a full range of medical and psychosocial risks and to refer patients for appropriate care throughout pregnancy. These services should be delivered in a variety of appropriate settings, and coordinated through the child's medical home. They also should be delivered in an efficient manner that does not compromise the quality of care. As these services are physician directed and prescribed, they should include but are not limited to all of the following: