As many of you may know, your health insurance plan under the Affordable Care Act covers one free annual wellness checkup; but, did you also know that your health insurance plan also covers preventative screenings, immunizations and other services free of charge? What services are free comes down to if the service is preventative or not and depends on your age. For example, colonoscopies are usually covered once you turn 50 as preventative yet would normally be billed as a diagnostic for a younger individual.
For adults, screenings for blood pressure, diabetes, colorectal cancer, breast cancer, cervical cancer, prostate cancer, sexually transmitted infections, HIV, osteoporosis and more are fully covered by your health insurance plan as long as they are billed as preventative and not diagnostic. It is extremely important to first speak with your doctor and use appropriate language when requesting a preventative service. Services may be billed as non-preventative and your out-of-pocket costs can get into the thousands of dollars depending on the service if you are not careful.
Free preventative immunizations for adults – Hepatitis A & B, Human Papillomavirus (HPV), Measles, Mumps & Rubella (MMP), Pneumonia, Tetanus, Varicella (chicken pox), Influenza (flu) and Zoster (shingles).
Free counseling for adults – Domestic Violence, Family Planning & Breast-feeding Support
Free preventative screenings for children: Diabetes, Weight, Height & BMI, Vision and hearing tests, Pelvic exam, Pap and HPV tests, sexually transmitted infections (STIs) for adolescents
Free preventative immunizations for children – Hepatitis A & B, Tetanus, Influenza, Haemophilus Influenza Type B (HiB), Inactivated Poliovirus Vaccine (IPV), Measles, Mumps & Rubella (MMP), Pneumonia, Varicella (chicken pox), Rotavirus, Meningococcal & Human Pappilomavirus (HPV)
You should always make sure to get your one free annual wellness checkup each year to check up on your vitals. The key to a healthy life is good nutrition and exercise as well as preventative care to address issues before they become major.
When you schedule your yearly check-up, make sure to indicate to the doctor that you would like to have a preventive care visit. The coding and paying system for preventive care and diagnostic care is different. We at Solid Health Insurance Services hear sometimes complaints from policyholders that they had to pay for their preventive services. However often the fact is that during the preventive exam the policyholders mentioned to the doctor that something beyond the preventive exam bothers them, and then suddenly the preventive visit is coded as a diagnostic visit, which then will require co-payments or payments against the deductible. So it is the best procedure to talk to the doctor clearly on how he or she will bill the visit if you ask a question or medical issue in the preventive visit so that you will not be surprised by any possible charges.
Our mission at Solid Health Insurance Services is to find you affordable health insurance, life insurance, long-term care insurance and travel insurance which fits your medical needs and budget for your individual, family and business needs. Please contact us at 310-909-6135 or at info@solidhealthinsurance.com