Although it might take some time to set up your free preventative exam with your in-network doctor, it is well worth taking advantage of this benefit. Most preventive care visits are scheduled between two to three month in advance, so start scheduling your preventive care visit .Any health insurance plan regulated by the Affordable Care Act offers 10 essential health benefits, including free preventative care. What exactly is preventative care? It is care that helps detect and prevent serious illnesses. Everyone should be taking advantage of the free preventative care benefit included in their health insurance. Keeping on top of our health is vital, and an annual wellness exam plays a key role in ensuring we remain in the best possible shape.
When scheduling your annual wellness exam, point out to the doctor that you wish only to discuss preventive measures so that the doctor is using only preventative codes for the bill. If you ask the doctor to check a specific medical issue, they may bill it as a diagnostic visit. The doctor should tell you the cost of the particular lab work if it is outside the scope of a regular preventive visit. Your plan’s copayment should cover this charge. Preventative exams are free of charge with an in-network doctor. Give them at least 2-3 months to set up the appointment.
List of Free Preventative Care Benefits (must use an in-network provider)
Comprehensive lists of preventative care treatments exist for children, women, and the general adult population. These lists may evolve over time, and healthcare providers might offer additional services that aren’t included under preventative care. Be sure to communicate with your healthcare provider and insurer.
- Annual wellness & women’s wellness exam (includes a review of past medical, family history, medications, and age-appropriate screenings)
- Flu, hepatitis A & B, MMR vaccinations
- Pap smear
- STD, STI screenings
- Women’s health screenings
- Mammogram (women over age 40)
- Breast exam (age 25-39)
- Pap smear
- Blood pressure & cholesterol screening
- Colonoscopy (starting at age 45)
California continues to prioritize preventative care to enhance the overall health and well-being of its residents. The state has implemented several key measures and policies to ensure that preventative services are accessible and effective.
In 2024, the government introduced new legislation to prohibit cost-sharing for specified preventative care services and screenings. This law ensures that patients can access services such as reproductive healthcare, HIV prevention medications, and screenings for sexually transmitted infections (STIs) without additional financial burden. Insurance carriers must now cover these services without charging out-of-pocket costs to the insured. With the current administration, this might be reversed.
If you have any questions about your plan benefits, please contact us at 310-909-6135 or email us at info@solidhealthinsurance.com for us to better assist you. At Solid Health Insurance Services, we strive to help our clients find the right health, dental, vision, life, and long-term care insurance which best fits their budget and medical needs.
