21 Feb ASK SAVA: Are some preventive care services free?
GRACE‐April 2011
Q – I am concerned about the new health care changes and how it affects preventive care services, are some still free?
A – Generally yes. Under the Patient Protection and Affordable Care Act (PPACA), qualifying health insurance plans must offer certain preventive care services to you and your family at no cost.
If your health insurance plan is subject to these new requirements, you and your family may be able to receive important preventive health-care services without having a co-payment, deductible, or co-insurance. Many of the covered services are based on your gender, health status, and age. Some of these services include:
• Blood pressure, diabetes, and cholesterol screenings
• Mammograms, colonoscopies, and many other cancer screenings
• Routine vaccinations against diseases such as measles, polio, and meningitis, as well as flu and pneumonia shots
• Wellness counseling for such issues as quitting smoking and losing weight
• Screenings for depression and alcohol abuse
A current list of preventive care services can be found on the government website: www.healthcare.gov.
To be eligible, you must be enrolled in a health plan through your employer or have individual health insurance put in place after March 23, 2010. The preventive care services will then be effective on the next policy anniversary occurring on or after September 23, 2010, or as of January 1, 2011, for calendar-year plans. If your health plan is “grandfathered” (in place on or before March 23, 2010, and has not been materially changed), these benefits may not be available to you.
Free preventive services may only be available for in-network providers (you may have to pay for preventive services received from an out-of-network provider). Also, if your doctor provides preventive services, such as cholesterol screening, and other diagnostic or therapeutic services during the same office visit, you may have to pay for part of the office visit and the other services given by your doctor, but not the preventive services.
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