Ryan McVay | Digital Vision | ThinkstockWe’ve all heard the phrase “an ounce of prevention is worth a pound of cure,” penned in 1734 by Benjamin Franklin. He wrote the line in a letter to his local newspaper, as a way of advocating for a volunteer fire department. At the time fires were a serious threat to Philadelphians, and Franklin knew that planning ahead for potential problems would reduce both the danger and the damage. Little did he know his words would become synonymous with preventive care in the medical community. That’s because when it comes to our health, diagnosing and nipping small problems in the bud can prevent catastrophic problems later on.

What Is Preventive Care?

Under the Affordable Care Act, preventive care includes a variety of routine screenings and wellness exams to diagnose and treat disease early, before it becomes serious, even life threatening. In fact, waiting to treat an illness until a person is sick is one big reason why health care costs in the U.S are rising. Many of us put off seeing a doctor until an illness is so serious or advanced that it requires expensive and complicated treatment. But under the Affordable Care Act, most health plans are required to cover certain preventive care services with no out-of-pocket cost.

The U.S. Department of Health and Human Services estimates that health care reform made 76 million Americans newly eligible for free preventive care, yet many people still aren’t aware these services are available. A Kaiser Health Tracking Poll last year showed that only 43 percent of the population knew about free preventive care, so many avoided those screenings and annual physicals because of concerns about the cost.

What’s Covered?

Among the 15 covered services for adults are immunization vaccines, blood pressure and cholesterol screenings, colon cancer screenings, HIV screenings and obesity screenings.

There are also 22 preventive care services specifically available to women at no extra cost within cost-sharing plans (which is how most health plans share costs between the provider and the insured), including many services for pregnant women. Some of the services for women include breast and cervical cancer screenings, contraception and well-woman visits. Forty-seven million women with private insurance can now also get mammograms with no co-pay, thanks to the Affordable Care Act.

There are 26 preventive care services for children, and those include immunization vaccines, vision screening, alcohol and drug use assessments, and depression screening for adolescents.

Preventive services and annual wellness visits are covered on major medical plans sold after 2014; and that means you don’t pay copays or coinsurance whether or not you have met your deductible for the year. Health insurance plans that existed before March 23, 2010, however, may not offer free preventive care services. According to the Kaiser Family Foundation, this includes more than a quarter of workers covered by employer-based insurance.

If you have questions about preventive care or have a plan that doesn’t cover those services for free, look to the professionals at HealthMarkets Insurance Agency for help. Call us at (800) 304-3414 or meet with one of our 3,000 local, licensed health insurance agents.


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