Preventative Care is made to help you stay healthy and to catch health issues early on before it becomes too difficult to treat. Most plans offer this service for free. You may have a few questions about what’s available to you for free and I’m here to answer those questions.
Preventive health encompasses a set of health services meant to screen and possibly identify health issues before symptoms develop. Preventive healthcare can help you live a longer, healthier life.
How does it work?
Preventative healthcare offers free services covered by your insurance even before you’ve met your deductible and without charging you a co-pay or coinsurance. The health services are meant to screen and help find health issues before symptoms develop. These covered services come from the Marketplace even private plans bought through the Marketplace are covered.
What’s covered?
Typical preventative Care covers routine health care, this includes screenings, check-ups, and patient counseling to prevent illnesses, disease, or other health problems. The coverage is broken down demographically into three categories for Adults, Women, and Children. Below is a list for each category:
Adults
Adult preventative care screens for diabetes, cancer and heart disease, and also provide immunizations. Typically, counseling is available for alcohol misuse, STI prevention, and healthy eating habits. Some of the most common preventative care for adults covers:
- Abdominal aortic aneurysm one-time screening for men of particular ages who have ever smoked
- Colorectal cancer screening for adults 45 to 75
- Cholesterol screening for adults of a particular age or at increased risk
- Diet counseling for those 40 to 70 years old who struggle with obesity
- Immunizations like Flu, HPV, Shingles and Tetanus
To see a comprehensive list of these services, click the following link: https://www.healthcare.gov/preventive-care-adults/.
Women
There is specific coverage for women who are or may become pregnant. Screenings for gestational diabetes, maternal depression, preeclampsia and more are available. Counseling for breastfeeding and tobacco are also provided.
Other covered preventative services for women includes well-woman visits, screenings for bone density, diabetes, breast cancer mammogram and counseling is also available for cervical cancer, breast cancer genetic test and breast cancer chemopreventative. Common screenings and counseling include:
- Breast cancer mammography screenings every 2 years for women 50 and older and for women at higher risk
- Breastfeeding support and counseling from trained professionals and access to breastfeeding supplies
- Diabetes screening for women with a history of gestational diabetes who aren’t currently pregnant and have no past history of type 2 diabetes
- Pap tests for women 21 to 65 years old
A detailed list can be found here: https://www.healthcare.gov/preventive-care-women/.
Children
Children (under 18 years old) have age particular coverage which involves immunizations, well-baby and well-child visits. They offer screenings for autism, depression, development, obesity, and vision. Alcohol, tobacco and drug use assessments for adolescents is also available.
- Blood screening for newborns
- Developmental screenings for children under the age of 3
- Immunizations such as chickenpox, influenza shot, mumps and rubella
- Vision screening for all children
- Well-baby and well-child visits
More detailed information about the age divisions can be found at https://www.healthcare.gov/preventive-care-children/.
What are the limitations?
Unfortunately, with all good things there are limitations. First, not all plans offer preventative coverage, only most so make sure the plan you choose has this benefit. Second, you must get the allowed free services from a doctor or other provider in your specific plan’s network. Preventative services for children have age limits. Lastly, before you set up an appointment for yourself or child call your provider to make sure the service you require is covered by your insurance plan for free. You can find out more info here: https://www.healthcare.gov/preventive-care-children/
Knowing the difference between preventative care and diagnostic testing can help you be aware of potential medical expenses. If you have been diagnosed with an ongoing issue such as high blood pressure and go for testing to see how it’s progressed that is diagnostic testing which is not free. Preventative screening to see if you may have high blood pressure would be of no cost to you. Any further testing to confirm or treat the health condition will not fall under preventative care.
What’s most important, etc…
There are a lot of screenings and counseling opportunities available and that can be overwhelming. However, knowing your immediate family’s medical history can help you prioritize what you should look into first. If your mother, father, or siblings have certain medical conditions you should mention this to your doctor and set up an appointment with your provider to screen for those health issues. This preventative care can help you treat any risks early on so it can be much more effective.
Getting screened for health conditions before they become unmanageable is great for your physical and mental health. Preventative care was made to keep you healthy and can save you healthcare costs if you catch illnesses early.
It is very important for you to look over your Summary of Benefits to see what your plan offers to you at no extra cost. Preventative care is to help you stay healthy and if possible, ward off medical issues before they become serious. Try to take advantage of your free benefits throughout your year of coverage.
Our agents Daniel Potter and Josiah Lee at Georgia Health Insurance can help you look over what your specific plan offers or help you enroll in a plan that will best fit your medical needs. Just give us a call or reach out to us via email at info@ga-health-insurance.com
