Any health insurance plan regulated by the Affordable Care Act offers 10 essential health benefits, including free preventative care. What exactly is preventative care? It is care that helps detect and prevent serious illness. Everyone should be taking advantage of the free preventative care benefit included in their health insurance. We all need to stay on top of our health and the annual wellness exam is absolutely critical to staying in the best shape possible.

When you are scheduling your annual wellness exam, please make sure that your doctor is correctly billing you for a preventative visit. If you start asking for the doctor to check on a given medical issue, they may bill your visit as a diagnostic visit which would be charged at your plan’s advertised copay.

List of Free Preventative Care Benefits (must use an in-network provider):

  • Annual wellness & women’s wellness exam (includes a review of past medical, family history, medications, and age-appropriate screenings)
  • Flu, COVID-19, hepatitis A & B, MMR vaccinations
  • Pap smear
  • STD, STI screenings
  • Women’s health screenings
    • Mammogram (women over age 40)
    • Breast exam (age 25-39)
    • Pap smear
  • Blood pressure & cholesterol screening
  • Colonoscopy (starting at age 45)
  • COVID-19 screening and testing
  • At-home COVID-19 tests (limitations apply)

During the first year of the COVID-19 pandemic, insurance carriers waived all member cost-share for both COVID-19 screenings & treatment, including hospitalization. In 2022, members are responsible for the member cost-share for COVID-19 treatment as illustrated in their health insurance plans. Please review your plan benefits to understand the cost of COVID-19 treatment. Please note that it is possible for COVID-19 testing to be billed as a diagnostic test once the COVID-19 pandemic emergency is scheduled to end as defined by the U.S. Department of Health & Human Services (scheduled to end on July 15th).

If you have any questions about your plan benefits, please contact us at 310-909-6135 or email us at info@solidhealthinsurance.com for us to better assist you. At Solid Health Insurance Services, we strive to help our clients find the right health, dental, vision, life, and long-term care insurance which best fits their budget and medical needs.