Preventive care is a crucial part of catching and treating chronic health problems early on as well as preventing illness entirely.
Most medical illnesses, such as heart disease or cancer, generally responds better to treatment when caught early.
Additionally, preventive care can help you to become aware of any risk factors for certain illnesses. In many cases, you can then work towards reducing your risk for an illness with medication and life changes.
In many cases, you can receive free or low cost preventive health care whether you have health insurance or not. Insurance companies does offer preventive health care coverage for adults and for certain coverage groups in which an individual is not charged.
If you do not have health insurance, you may be eligible to receive free or low cost preventive care by visiting your local health center. For more on how to get free preventative health care, review the information that has been provided within the sections below.
Insurance Covered Preventive Care for All Adults
Under Obamacare, also known as the Affordable Care Act, you can receive certain preventive care services, such as medical screenings and vaccinations, so long as you stay within your provider’s network and coverage limitations.
This preventative care coverage is required by law regardless of age, sex, plan cost or your risk level. The preventative care services that must be included within an insurance’s health plan include:
- Alcohol misuse screening and counseling
- Depression screening
- Blood pressure screening
- Tobacco use screening and counseling
- Obesity screening and counseling
- Recommended immunizations
Recommended immunizations will vary depending on recommended ages and populations, but immunizations may include:
- Hepatitis A and B
- Herpes Zoster (shingles)
- Human Papillomavirus (HPV)
- Influenza (the flu)
- Measles, mumps and rubella
- Meningococcal
- Pneumococcal
- Tetanus, diphtheria and pertussis
- Varicella
Insurance Covered Preventive Care for Selected Groups
In addition to the above preventative care that must be covered under your insurance policy, Obamacare plans will provide additional preventative care depending on your risk factors for certain conditions.
As an example, if you are a current or former smoker who is at risk for lung cancer and aneurysms, you may be eligible to receive a screening for these conditions at no cost to you. Other screenings that may be offered by your insurance provider, depending on your risk factors, include:
- Aspirin use to prevent heart disease in certain men and women who are within certain age groups
- Cholesterol screenings for adults within certain age groups and those who display a higher risk for high cholesterol
- Colorectal cancer screenings for adults who are over the age of 50
- Diet counseling for adults who are at risk for several chronic diseases
- Hepatitis B and C screenings for adults that are considered high risk
- HIV screening for anyone between the ages of 15 and 65
- Lung cancer screening for adults between the ages of 55 and 80, or for those who are heavy smokers or those who have quit within the past 15 years
- Prevention counseling for sexually transmitted infections for high risk adults
- Syphilis screening for adults who are at a higher risk
Additional screening is provided to women, including screenings for breast and cervical cancer. Pregnant women are provided with additional screenings and preventive care services.
While these screenings are free and at no cost to you, you must ensure that you stay within your insurance provider’s network in order to receive coverage.
What to do Before Your Preventive Care Appointment
It is important to be aware of any potential charges that you may incur from your preventive care services. While these screenings are available at no cost to you, you could potentially incur other charges during your health care visit.
Health care providers charge your insurance per service, not per visit. So you could potentially still be charged for something relating to the visit, such as a facility fee or charges incurred from seeing your doctor to discuss the results of your screenings.
Generally, any fee that you incur should be very small and will likely come in the form of a one-time copayment or a coinsurance payment of up to 20 percent of the charges that were not considered preventive care.
In order to ensure that you minimize your costs, it is important to do the following prior to your preventive care appointment:
- Review your insurance policy summary in order to find your copayment amounts.
- Make sure that the laboratory that will be completing your testing is within your insurance provider’s network.
- If you decide to have more than one screening at a time, try to group these screenings into as few doctor visits as possible in order to reduce the amount of facility fees and copayments that you may be expected to pay.
Preventive Care Services Through a Health Center
Found throughout the United States, heath centers are community-based organizations that provide a variety of health care services at little to no cost to patients. These centers will generally offer pharmacy, mental health, substance use disorder, oral health services and preventive care services.
Most health centers are federally funded and must meet certain requirements regarding administrative, clinical and financial operations. Health centers provide medical services regardless of an individual’s ability to pay for the services and most offer sliding scale fees where the cost of a service will depend on an individual’s income.
Therefore, if you cannot pay for a service up front, they will bill you so that you can pay at a later date.
Health centers are invaluable to those without insurance and are often referred to as “free clinics”. You can be seen at a health center, even if you do not possess health insurance.
The downside of a health center is that they are generally very busy with long waits as patients are often seen on a first come first serve basis. Additionally, many centers may have limited hours and days in which a center operates.
