Healthy Habits

Understanding Preventive Care

Annual preventive care is crucial for overall health. Staying on top of regularly scheduled doctor appointments, screenings, vaccinations, and disease management can make all the difference in catching a health problem in the early stages. This article outlines the difference in necessary preventive screenings amongst females, males, and children and provides a few helpful resources to stay current and in control of one’s health.

Did You Know? According to the U.S. Centers for Disease Control and Prevention (CDC), 7 out of 10 Americans die each year from chronic diseases, many of which are preventable.

Adults

As we age the list of preventive screenings increases. This is to ensure a developing disease is detected and treated prior to becoming unmanageable. Beginning at the age of 18, adults should undergo these preventive screening exams. Please consult with a doctor to confirm what applies to your health and circumstances.

  • Physical exam
  • Sexually transmitted disease
  • Body mass index
  • Blood pressure
  • Mental health screening

Females

Ask a provider about cervical exams, breast cancer screenings, lipid disorder exams, and colorectal exams.

In addition to National Mammography Day on October 16, Breast Cancer Awareness Month is also recognized in October. Take time to schedule an appointment for a mammogram or encourage the women close to you to do so. According to the CDC, regular mammograms are the best tests doctors have for finding breast cancer early, sometimes up to three years before it can be felt.

Males

Ask a provider about lipid disorder exams, colorectal exams, and prostate screenings.

Children

Beginning at a few days old it is recommended that children receive the appropriate screenings and vaccinations to ensure good health. Visit https://www.healthcare.gov/preventive-care-children/ to review preventive screening requirements for children ages newborn to 17 years old.

Resources

Knowing what is recommended and expected at a preventive care visit can be daunting. Try out this calculator found on https://health.gov/myhealthfinder to see what a doctor recommends based on age and gender. Make sure to ask questions to stay in charge and maintain good health.

Other Helpful Tips

Read below to learn about the types of care that are generally covered by insurance providers, billing guidelines to be aware of, and the importance of provider care amidst COVID-19.

Preventative Services Covered by Insurers

According to Healthcare.gov, most health plans must cover a set of preventive services at no cost to the insured, such as immunizations and screening tests. Services are only covered at no cost when obtained by a provider within the health plan’s network. Adult preventive services may include testing blood pressure, cholesterol, mammograms, immunizations, and screening for diabetes. Child preventive services may include well-child checks, hearing, vision, immunizations, and developmental screenings.

Visit https://health.gov/myhealthfinder to learn more about preventive care.

Avoid Surprise Billing Expenses

It is important to be aware of what is covered as preventive care to avoid surprise billing expenses. Once the preventive portion of the visit is complete, oftentimes a patient may have additional questions for the physician that can be unrelated or outside the scope of “preventive services.” Once the conversation turns away from preventive care, it can be billed as a different type of visit and can include out-of-pocket expenses. Addressing non-preventive concerns is important – just be aware these services may be billed differently. Check with your health plan for specific guidelines on what is covered under preventive care at no cost.

Don’t Ignore or Delay Health Care Needs During a Pandemic

Putting health care on hold during a pandemic can lead to serious health problems in the future, particularly for patients who are due for immunizations or who experience conditions that require monitoring. It is important to identify ways to continue receiving care during unprecedented times. When needed, explore virtual or telehealth options being offered as an alternative to ensure continuity of care.

References
https://www.healthcare.gov/preventive-care-women/
https://familydoctor.org/mens-guide-preventive-health-care/
https://www.sanfordhealth.org/campaign/care-during-covid19

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