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Follow this authorDid you know that your health insurance covers a variety of screenings, counseling services and immunizations at NO cost to you? Zero, zip, zilch out of your pocket.
That’s right, the Affordable Care Act (ACA) requires that all health plans cover recommended preventive services at no cost to the individual. These recommended services — things like cholesterol testing, colonoscopies and screenings for a healthy pregnancy and baby — can keep you healthy and detect any issues before they become major health (and financial) concerns.
Here’s everything you need to know about free preventive care through your health plan:
Who: You! Men, women and children are all covered.
What: Depending
on your age, you may have access — at no cost — to preventive services such as:
• Blood pressure, diabetes, and cholesterol tests
• Many cancer screenings, including mammograms and colonoscopies
• Counseling on topics such as quitting smoking, losing weight, eating
healthfully, treating depression and reducing alcohol use
• Regular well-baby and well-child visits, from birth to age 21
• Routine vaccinations against diseases such as measles, polio or meningitis
• Counseling, screening and vaccines to ensure healthy pregnancies
See the full list at Healthcare.gov.
When: Now. These preventive services are already covered under your health care plan.
Where: Preventive services are free when delivered by an in-network doctor from your plan.*
Why: Preventive care screening can detect disease in the early stages when it is most treatable.
Following preventive care guidelines, along
with the advice of your doctor, can help you stay healthy.
How: Know what’s considered preventive care and review the guidelines.
For example, although colonoscopies are a preventive care screening, it’s only
covered for people age 50 or older.
Additionally, colonoscopies that are done to evaluate specific problems are usually classified as diagnostic procedures (not screenings) and are not covered.
Avoid unexpected costs by clearly stating when you make your appointment that your visit is for a covered preventive care service. For example, if you’re making your well-women visit on the phone say “I’m making an appointment for my free preventive care well-women visit.”
Also, medical complaints aren’t preventive. If you have other issues to discuss with your doctor it is no longer preventive and you’ll be charged a fee. For example, if during your well-women visit your doctor does blood work for thyroid problems you are having, these additional services won’t be covered under free preventive care. Don’t hesitate to ask your doctor whether screenings they recommend will cost you.
*Under ACA, most health care plans are required to cover preventive care services at no cost to the individual. There are some plans (called “grandfathered” under the law) that don’t have this requirement. (A recent survey conducted by the International Foundation of Employee Benefits Plans found that 18% of corporate plans are grandfathered.) Be sure to check with your health plan or HR department to learn more.
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