What Counts as Preventive Health Care?

What Counts as Preventive Health Care?

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You usually have to dip into your wallet to see the doctor, but with most insurance plans — including any you buy on the Marketplace — there’s one thing that’s totally covered: preventive health care.

What Is Preventive Care?

Many basic services count as covered preventive care, from general services to specific types for men, women and children. Generally, they fall into one of three kinds of care:

  • Primary preventive care services that help you stay healthy, like vaccines.
  • Secondary preventive care services that detect or mitigate existing health issues or threats, such as cancer screenings.
  • Tertiary preventive care services that improve life with an existing health need, like obesity counseling or breastfeeding support for nursing mothers.

All three are important to cover as many situations and help as many people as possible. Rest assured that there’s no catch or financial strings attached — basic preventive services are required by law to be covered. Per the Affordable Care Act (ACA), traditional insurance plans have to cover these services without charging copays or coinsurance, regardless of whether or not you’ve met your deductible.

And while the term “preventive care” may seem vague, the law isn’t. Check these links from HealthCare.gov to see a detailed list of covered services:

Why Should You Get Preventive Care?

It’s no surprise that these services are covered: They save lives. According to the Centers for Disease Control and Prevention, if everyone received recommended preventive health care, more than 100,000 people could be saved every year. But far too often, people skip out on it. Some reports estimate that as few as 1 in 10 Americans get preventive care services.

Preventive care is kind of like lifelong maintenance for a healthy body and mind, the same way routine oil changes are part of vehicle upkeep. Along with healthy choices like eating well and staying active, regularly getting basic preventive services should be a priority at every age.

When Do You Need Preventive Care?

While you should always see a health professional if you have any concerns or feel unwell, it’s important to schedule a few key preventive services when recommended. You can’t use cost as an excuse not to get them: If you have an ACA health plan, they’re free!

  • Get a blood pressure reading every two years to help prevent organ problems with your heart, brain, kidneys and eyes.
  • Talk with your doctor if you think you may have depression so that you can get the resources to feel better.
  • Get screened for HIV so that you know your status, both for yourself and for any sexual partners.
  • Follow recommended immunization schedules, including receiving an annual flu shot, to protect against infectious diseases.
  • For women, schedule yearly well-woman visits. Pregnant women should also get regular prenatal care.

These are just a few examples of preventive care. What you need to manage your health may not be exactly the same as the services mentioned here, and different still from those of the people around you. Find a primary care provider who understands your health goals and medical history to go over your health needs, both preventive and otherwise, as you get older. They’ll help you keep feeling your best through office flu season and beyond.

Bana Jobe

Bana Jobe is an award-winning medical writer with over 10 years of experience

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