Preventive care helps to save lives by allowing for early detection and treatment of a wide range of chronic diseases. Most diseases, including many forms of cancer, are easier to treat early on. By communicating with your doctor about your family history you may also be able to prevent illnesses such as high blood pressure, diabetes, and more.
Speak to your primary care physician to stay on top of your preventive health care to begin screening and treating health problems early.
Preventive care means medical services that focus on preventing disease and evaluating a patient’s current state of health. Examples include annual well-woman visits, most immunizations, and screening tests such as mammograms. The Affordable Care Act requires private insurance plans to cover recommended preventive services without imposing cost-sharing (e.g., copayments and coinsurance) on patients receiving them. This ACA requirement applies to all private insurance plans except for those with “grandfathered” status. To earn grandfathered status, a plan must have been purchased before March 23, 2010, the date the ACA was signed into law. Grandfathered plans are also prohibited from making significant changes to coverage, such as increasing patient cost-sharing, cutting plan benefits or reducing employer contributions. An insurance plan is required to disclose whether it has grandfathered status.
What qualifies as a covered preventive service under the ACA?
You might be familiar with preventive care recommendations issued by medical organizations such as the American Academy of Family Physicians or the American Academy of Pediatrics. But, as Salganicoff explains, it’s important to distinguish between preventive services that are recommended by professional organizations and those that have the power of law under the ACA’s preventive services benefit. “When an organization like the ACOG [American College of Obstetricians and Gynecologists] issues preventive care recommendations,” she says, “those guidelines are aimed at practitioners and have no force for purposes of insurance coverage.” Instead, in order to qualify as a covered preventive service under the ACA, the service must be recommended by one of four expert medical and scientific bodies:
- The US Preventive Services Task Force: The USPSTF is an independent volunteer panel of national experts in disease prevention and evidence-based medicine. Insurance plans must cover any services for adults that have an “A” or “B” rating from the task force. A full list of all preventive services with an “A” or “B” rating is available on the USPSTF website.
- The Advisory Committee on Immunization Practices: The ACIP is a federal committee composed of medical and public health experts, convened by the Centers for Disease Control and Prevention to develop recommendations for vaccine usage. The guidelines issued by the ACIP address immunizations for both adults and children, including those for the flu, meningitis, tetanus, and hepatitis A and B. A complete list of ACIP-recommended immunizations can be found here.
- The Health Resources and Services Administration’s Bright Futures Project: The Bright Futures Project provides recommendations relating to the health and wellbeing of infants, children and teenagers. The preventive services covered under the ACA for these groups include immunizations, behavioral and developmental assessments, and screenings for autism, vision impairment, tuberculosis and certain genetic diseases. A complete list of the current services recommended by the Bright Futures Project and covered under the ACA can be found here.
- The HRSA Women’s Preventive Services Initiative: In addition to coordinating the Bright Futures Project, the HRSA also issues guidelines for preventive services for women. In 2011, the HRSA adopted recommendations proposed by a committee from the Institute of Medicine. In 2016, the HRSA awarded a contract to ACOG to develop recommendations, and from that agreement the Women’s Preventive Services Initiative was created. The current preventive care recommendations for women include screening for cervical cancer beginning at age 21, mammography screening beginning at age 40 (for women with an average risk of breast cancer) and an annual well-woman exam. Here’s a full list of current recommendations for women.
Address Health Concerns Today For a Better Tomorrow
Preventive care visits can improve your quality of life. Treatments that are classified as preventive care help to save 100,000 lives in the United States a year. Schedule your routine checkup to promote a healthy and happy future.
Supreme Medical Center in Houston
When it comes to getting better fast, the best thing you can do is schedule an appointment with your physician at the first sign of illness. At Supreme Medical Center our doctors work with you to treat your symptoms and get you back to feeling like yourself in no time.