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An Ounce of Prevention is Worth a Pound of Cure | New York Employee Benefits Firm

Health care is expensive but there is good news: Most insurance plans come with free preventive care and benefits.  There is a lot of confusion around what is and isn’t preventive care – and why it matters.  Here is what you need to know.

What is Preventive Care and Why Is It Important?

Preventive care is routine health care that includes screenings, services and counseling to help prevent illness, disease or other health problems. It is care that helps detect or prevent serious diseases and other medical issues before they become worse.

When you subscribe to a health plan—regardless of whether it’s one offered by your work or one you purchase in the marketplace—most plans will include an array of preventive care services free of charge if you use an in-network provider.  Due to the Affordable Care Act (ACA), plan providers are required by law to offer basic preventive care services to you and those covered by your plan with no additional copay, coinsurance, or requirement to meet a deductible.

So why should you go to the doctor when you’re healthy?  The simple answer is that preventive care can help you stay healthier and, as a result, lower your health care costs.  It can also help identify health problems earlier like diabetes, high blood pressure, or even cancer, when these diseases are most treatable.

Preventive Health Care Examples

  • Annual Checkups – This is when your primary care physician checks your overall health. These visits are a great opportunity to bring up anything you may be worried about with your doctor.
  • Immunizations – These include Tdap (Tetanus, Diphtheria and Pertussis) boosters, and immunizations against Pneumococcal Conjugate and Shingles. Your annual flu shot is also covered.
  • Cancer Screenings – Most people don’t experience cancer symptoms when it is in the earliest, most treatable stage. That’s why it’s important to have regular screenings throughout your life.  Preventive screenings for women include pap test and mammograms.  It’s also recommended that both men and women begin colorectal cancer screenings starting at age 45.
  • Tests and Screenings – These include tests for blood pressure, cholesterol, diabetes, obesity and depression
  • Pediatric Screenings – These include screenings for hearing, vision, autism and developmental disorders
  • Colonoscopy – 1 typically every 10 years, usually after the age of 50
  • Mammogram – 1 per calendar year, usually after the age of 40

Unfortunately, most people in the United States are not taking advantage of preventive care.  In fact, one study from 2018 found that only 8% of adults 35 and older received the preventive care recommended to them.  Today, the vast majority of deaths in America stem from preventable chronic diseases and 90% of the nation’s $4.1 trillion in annual health care spending goes for people with chronic and mental health conditions.

The U.S. Department of Health and Human Services has provided lists of preventive services that must be covered by most health insurance plans.  Lists are available for adults, women and children.  Click here for the lists of covered preventive care services.

Preventive health services offer significant health benefits and are covered by most insurance companies. In other words, participating in preventive care usually won’t cost you anything.  So, go get those freebies – and improve your health – while you’re at it!