Preventive Care Under the Affordable Care Act
Under the Affordable Care Act, you and your family may be eligible for certain preventive services at no additional cost to you. These services can help you avoid illness and improve your health.
What This Means for You
If your plan is subject to these new requirements, you do not have to pay co-insurance, a copayment, or deductible to receive preventive health care. Depending on your age, you may have free access to preventive services such as:
- Blood pressure, diabetes, and cholesterol test
- Many cancer screenings, including mammograms and colonoscopies
- Counseling on important issues such as weight loss, healthy eating, alcoholism, and depression
- Routine vaccinations against diseases, including measles, polio, or meningitis
- Flu and pneumonia shots
- Counseling, screening, and vaccines to ensure healthy pregnancies
- Regular well-baby and well-child visits, from birth to age 21
Some Important Details
- If your plan is considered “grandfathered” (purchased on or before March 23, 2010), these benefits may not be available to you.
- Be aware that if your health plan uses a network of providers, your plan is only required to offer these preventive measures through an in-network provider. Your health plan may allow you to receive preventive care from an out-of-network facility, but may charge you a fee to do so.
- Your doctor may provide a preventive service, such as a cholesterol screening test, as part of an office visit. Be aware that your plan may require you to pay some costs of the visit (either a copayment or coinsurance). This will happen if the preventive service is not the primary purpose of the visit, or if your doctor bills you separately for any preventive services incurred during an office visit.
If you have questions about whether these new provisions apply to your plan, contact your MediCoverage agent at (800) 930-7956
To know which covered preventive services are right for you—based on your age, gender, and health status—ask your health care provider.
Comments and Questions
Click to leave a CommentComment from Tim Thompson on November 05, 2011
Nice post. This kind of info is useful for everyone that needs to get their annual physical. I’m glad its not going to cost any additional money any more.
Comment from maryland botcher on October 20, 2011
Health care is very necessary now a days.. The Protections and benefits in the insurance is must. But the old system allowed the private insurers to sell benefits that are not medically necessary, such as cosmetic surgery benefits. Will the new coverage under obama care allow for that?
Comment from marialijoseph on October 17, 2011
Just to clarify it says” Insurance plans in effect before March 23, 2010, that have not undergone significant changes in cost-sharing and other design changes are considered grandfathered and do not have to comply with the new fully covered preventive care rules.”
What do they mean by significant changes in cost sharing?????
Comment from Rosenda Lett on October 08, 2011
Free preventive Care is really good. My old plan used to nickle and dime me every time I went in for a PAP. Actually it was more like $100s of dollars in test not nickles and dimes. The Affordable Care Act is really nicely made and involves many benefits which can prove beneficial to the members. Thanks for sharing such a valuable information.
Comment from DelMar on September 29, 2011
Thanks for the post! by the way. Starting on September 1, 2011, the Affordable Care Act requires health insurers seeking to increase their rates by 10 percent or more in the individual and small group market to submit their request to experts to determine whether the rates are unreasonable. The Affordable Care Act also requires insurance companies to publicly justify unreasonable premium rate increases. That is food for thought..
Comment from delbert lobo on September 20, 2011
Thanks for providing useful information. I appreciate your professional approach to health insurance explaination. Thank you for the efforts you made in writing this post. I am hoping i’ll see more helath care reform articles.
Comment from jonathanjames1930 on August 22, 2011
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Comment from kim salamanca on August 22, 2011
I would like to thank you for the efforts you have made in writing this article and i am hoping the same best work from you in the future as well. the affordable care act is confusing but this helps