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What is preventive care?

What is preventive care?

Because of recent policy changes, everyone’s health insurance now comes with free preventive care.

The key idea here is...wait for it...prevention. Certain types of tests and doctor visits can help you stay on top of your health and catch diseases or health problems before they grow serious. A lot of different services fall into this category, like mammograms, vaccines, diabetes screenings, and more (we’ll dig into the full list later on). Ideally, by keeping up with your regular check-ups, you’ll stay healthier.

How does it work?

All plans are required by law to cover preventive care, so if you go in for a service, you will not be charged anything (not even your copayment or coinsurance).

A few things to keep in mind:

  • Doctor visits that are diagnostic—meaning you already have symptoms and need a diagnosis—are not free.
  • The doctor you see must be in-network for it to be covered.
  • You must be the right age for certain tests. For example, to get a free mammogram, you must be over 40; for no-cost colorectal cancer screenings, you must be over 50.
  • Extra tests or follow-up visits are considered diagnostic, not preventive, so you'll be charged for those. If you go get your annual physical and your doctor runs a non-routine test, you'll have to pay for it (we know, super cool).

Pro Tips

  • When you're booking your appointment, let the office know right off the bat you want a preventive visit. Using terminology like "annual physical," "well-woman visit," etc. can help them book the appointment correctly and make sure you're billed properly.
  • During your visit, don't be afraid to ask questions. If your doctor wants to run a test, ask him/her if you'll be charged for it. Doctors like when patients ask questions, so be open...the more you know, the fewer surprises you'll get on your bill.
  • When you're leaving your appointment, let the billing office know your visit was preventive. Gentle reminders never hurt, and may prevent you having to deal with denied claims later on.

Services That Are Considered Preventive

Here’s a list of common services that are fully covered by your plan. There are many more services that are also covered, so check out the extensive lists on HealthCare.gov for adultswomen, and children.

Adults

  • Alcohol misuse screening & counseling
  • Blood pressure screening
  • Cholesterol screening
  • Colorectal screening (must be over 50)
  • Depression screening
  • Type 2 Diabetes screening (must have high blood pressure)
  • Immunization vaccines
  • Obesity screening
  • Tobacco-use screening and help quitting

Women

  • Breastfeeding support and counseling
  • Cervical cancer screening
  • Domestic & interpersonal violence screening and counseling
  • Mammograms (every 1 - 2 years if you’re over 40)
  • Well-woman visits: An important annual check-up that includes breast exams & Pap tests, shots if you need them, and counseling to make sure you’re healthy!

Children

  • Autism screening (if your child is 18-24 months)
  • Blood pressure screening
  • Depression screening (for adolescents)
  • Hearing screenings for newborns
  • Height, weight, & BMI measurements
  • Immunization vaccines
  • Obesity screening and counseling
  • Vision screening

So excited your plan comes with free things you can hardly stand it? Check out this post about other free or discounted perks that come with health insurance.