Get the most out of health insurance with free preventive care services

Because of the Affordable Care Act, most health plans must now cover a set of preventive services like shots and screening tests that can help one stay healthy. This includes Exchange/Marketplace insurance plans, and most private insurance and employer plans. And the best news is, they’re free*, with no co-pays or deductibles, as long as the services are delivered by a doctor within one’s insurance network.

The premise behind providing these preventive care screenings free of charge, is that insurance plans want to help their patients stay as healthy as possible – and hopefully prevent them from needing serious medical services down the road.

Getting the right screenings and medical tests at the right time can help prevent many illnesses, and stop others before they become serious or even present symptoms. Depending on a person’s age, gender, and other risk factors, a doctor may tell them it’s time for an anemia, diabetes, breast cancer screening, or other screening that can detect cancer or disease in its earliest, most treatable stages. Or, it may be time to screen for high blood pressure or high cholesterol to give the doctor information that can help prevent a stroke or heart attack. The doctor may also suggest tests, screenings or counseling for the following and more:

• Diabetes

• Depression

• Obesity

• Hearing or vision loss

• Sexually transmitted diseases

There’s even more good news for women. Many preventive care screenings, tests and supplies that can help with family planning and pregnancy are now covered, along with services such as:

• Well-woman checkups

• Contraceptives and birth control counseling

• Screenings during pregnancy for a variety of conditions

• Breastfeeding supplies, support and counseling

Most insurance plans also cover preventive care services for children*, depending on age and risk factors:

Screenings for autism, high blood pressure, some cancers, depression, developmental disorders, lipid disorders, hearing problems, blood diseases, HIV, hypothyroidism, lead levels, obesity, PKU, and vision problems.

• Behavioral assessments

• Fluoride and iron supplements

• Height, weight and body mass index measurements

• Immunizations for a variety of conditions

• Medical history

• Obesity counseling

• Oral health risk assessment

• Sexually transmitted infection prevention counseling and screening

• Tuberculin testing

If one’s insurance covers preventive care services at no charge, skipping them is like leaving money on the table. People should talk with their doctor about how to get the most out of their insurance plan. Those who don’t have a regular doctor are welcome to call Fallbrook Healthcare Partners at (760) 731-8989 or visit http://www.FallbrookHealthcarePartners.com for more information.

*Preventive care services often depend on age and risk factors. Depending on an individual’s health insurance, preventive care services may be covered without having to pay a copayment, coinsurance or meet one’s deductible. This applies only when patients use their plan’s network providers. To confirm their level of coverage for preventive care and to make sure their insurance is on their doctor’s list of accepted plans, they should check with their insurance provider, employer or doctor’s office.

About the authors:

Dr. Delgadillo is an internal medicine physician trained to diagnose and treat many chronic medical conditions such as diabetes, high blood pressure and pulmonary and heart diseases. He is board-certified in internal medicine and spent over 25 years in private practice near Chicago before joining Fallbrook Healthcare Partners. Dr. Delgadillo is fluent in Spanish.

Dr. Reynolds is an internal medicine physician trained to diagnose and treat many chronic medical conditions such as diabetes, high blood pressure and pulmonary and heart diseases. He is board-certified and a Diplomat, American Board of Internal Medicine and American Board of Internal Medicine, Pulmonary Diseases. He has been a resident of Fallbrook since 1994 and member of the medical community for more than 10 years before joining Fallbrook Healthcare Partners.

Dr. Toupin is a family medicine physician who treats a broad range of healthcare needs, from preventive medicine to disease management. He offers care for the whole family, from babies to seniors. He is board-certified with the American Board of Family Medicine, and practiced in the Chicago area before joining Fallbrook Healthcare Partners.