“An ounce of prevention is better than a pound of cure,” goes a much abused cliché. It has proven time and again how preventive care has spared Americans thousands of dollars in hospitalization and medical bills. Its importance has been recognized by Obamacare, which stipulates that preventive care should be covered on all major medical plans sold after 2014. They would also be given at no out-of-pocket cost and with no copays or coinsurance.
What Is Preventive Care?
This refers to services that evaluate your overall health even if you are not showing any symptoms or signs of disease. Its primary goal is to obtain early diagnosis to keep the health condition from escalating into a life-threatening disease. This also covers anything that will help ensure that you are at the pink of health as much as possible, such as immunization.
Preventive Services Under Obama Care
The law requires that at least 15 preventive care services be included in major health plans. Obamacare preventive services, however, cover a much wider range of scope.
- At 18 and 24 months, children can be submitted for Autism screening at no cost to the insurer. This is usually done during well-child visits. So make sure that your health plan covers well-child visits.
- Children ages 0 to 11 months and 1 to 4 years can avail of behavioral assessments. The preventive service will continue to ages 5 to 10 years, 11 to 14, and 15 to 17. A telling sign that your child my need this type of assessment is when he has trouble following directions.
- Children can take advantage of blood pressure screening which will help determine if they are at risk for hypertension and other heart-related diseases.
- Children below 3 years old can undergo developmental screening. If your child is not learning to talk on schedule, have him screened for developmental problems.
- Children with higher risk of developing lipid disorders can undergo dyslipimedia screening at ages 1 to 4 years 5 to 10, 11 to 14 and 15 to 17. Early detection can help prevent certain abnormalities, such as High triglycerides or High total cholesterol.
- All newborns will receive gonorrhea preventive eye medication. This is part of a comprehensive screening done on newborns.
- Adolescents can get tested for possible depression, helping reduce the risk of them developing depression. Children ages 12 to 18 should be checked for depression, because more than 1 out of 10 teenagers show related signs. If not detected early, it can be life-threatening, as some depressed teens resort to suicide.
The list is not exhaustive as there are a total of 26 preventive services that children are entitled to under Obamacare.
Specific provisions of Obamacare was designed for women in 2012. These include but not limited to the following.
- Breast cancer genetic test counseling (BRCA) for women that are at higher risk of developing breast cancer.
- Anemia screening for expectant mother to be done on a routine basis. Iron deficiency in pregnant women can have serious effects to the fetus. This is why expectant women should have routine iron deficiency testing that can help improve maternal hematological indexes.
- Access to free contraceptive and sterilization methods provided that they are approved by the Food and Drug Administration and are prescribed by a health care provider.
- Sexually active women can have HIV screening and counseling, and sexually transmitted infections counseling at no out-of-pocket costs.
- Sexually active females can get tested for cervical cancer through cervical dysplasia screening. This usually involves Pap tests required for women of specific ages. Women age 21 to 29 should undergo Pap tests every 3 years, and 30 to 65 every 3 years with the addition of HPV test every 5 years.
- Women under 65 get recommended services during well-woman visits. These include physical exam, documentation of your health history and habit, and development of health goals.
- Under Obamacare, there are 22 preventive services for women.
- Men aged 65 to 75 and who have ever smoked can undergo Abdominal Aortic Aneurysm (AAA) one-time screening if they meet the specified ages. When discovered early, AAA can be treated to prevent the artery from bursting.
- Aspirin use counseling for men aged 45 to 79 and women aged 55 to 79. It is vital to talk to your doctor about using aspirin to prevent cardiovascular disease, especially if you smoke or at high risk of high blood pressure and cholesterol.
- Cholesterol screening for men age 35 and older, men aged 20 to 35 with a high risk of heart disease, and women aged 20 to 35 who are also at high risk of heart disease. Early detection of high cholesterol help prevent risks of high blood pressure, diabetes and atherosclerosis.
- Adult immunization for a wide range of diseases, such as Hepatitis A and B, Influenza, Human Papillomavirus, Meningococcal, Herpes Zoster, Pneumococcal, Varicella and Tetanus.
- All adults at high risk of syphilis can undergo free screening to check for the presence of germ, bacterium or antibodies that may cause syphilis. Early detection can prevent brain damage, blindness, and heart disease that may be caused syphilis infection.
Of all Obamacare preventive care services, the wellness visit is a common denominator – well-child visit, well-women visit, and adult wellness visits. To ensure that you make the most of these visits, see that your doctor uses the correct preventive code when billing the insurance company. Otherwise, you might end up paying for a service that is supposed to be free.
So, during a visit, ask your doctor how a particular service will be coded. You can then refer to your insurer to confirm that the correct code is used to avoid your claim being denied. To avoid a lengthy process, ask your insurer first about the codes and then check the code that your doctor used. In the event that your claim is denied because of an incorrect code, you can always ask your doctor to recode, so you can appeal.
You should take advantage of preventive services to avoid staggering hospitalization and medical bills. Thanks to Obamacare, you can obtain them at no cost to you.