Since health insurance is now required to cover much preventive care free of charge (except for some plans written prior to passage of the ACA), we should understand how best to take advantage of it. What’s covered? A lot. But you should definitely be aware of the following covered screenings, prevention counseling, and other interventions, that can help you get healthy and stay healthy.
If Franklin lived today, he’d definitely see the sense in getting his yearly checkup. (Especially because he’d be over 300 years old!) If you are under 40, healthy, and happy, you may not need a checkup (or preventive health care visit, as your plan may call it) every year. But if you’re older, if you’re sick, or have disease in your family history, you probably do. The easiest way to know? Ask your doctor how often he or she wants to see you—then make and keep those appointments.
Before your checkup, take some time to consider all the health issues and questions that may have concerned you since the last time you saw the doctor. Make a list to take with you. And check with close friends and family if it will help to jog your memory. They may remember concerns you may have forgotten.
Flu Shots and Other Vaccines
Your post-ACA plan is required to cover a yearly flu shot and other vaccines—like a 10-year tetanus booster—that adults may need. Just check with your plan to find out where you need to go, as some plans limit locations. There are more than a few reasons to be sure to get a flu shot each year.
Contraception for Women
Unless your employer has a religious exemption, post-ACA plans must cover FDA-approved contraceptive methods, sterilization procedures, and patient education and counseling, as prescribed by your healthcare provider. There is some other fine print about generics and name-brands. Make sure you understand what your benefits are, as even pharmacies and insurance companies occasionally get it wrong.
Several types of cancer screenings are covered at no-cost: lung cancer and colorectal cancer screenings for adult patients who meet the screening guidelines, as well as breast cancer and cervical cancer screenings for women. Look into the guidelines for your age group, or ask your doctor, as early detection gives you your very best chance at fighting most cancers.
Diabetes and Obesity Screening
Getting your weight in the healthy range can help to head off a host of health problems down the line: from diabetes to heart disease to cancer. If you’re overweight or at risk for diabetes, your screenings and some counseling are covered by your post-ACA plan.
Much, Much More
Want to know what other care your post-ACA plan provides for free? There’s a pretty long list.
If you’re a woman, be sure to check the list specifically for women, as well as the one for adults in general, as both lists apply to you. Have kids? Here’s a list showing what’s covered for your children.
One more word of advice: It’s a good idea to check with your insurer before scheduling any of these visits. Make sure you know of any network restrictions or requirements and that you and your insurer are on the same page as to how they interpret these relatively new guidelines. If you think they’re not reading them right, you can always appeal their decision. Here’s how.