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An Ounce of Prevention
"An ounce of prevention is worth a pound of cure."
- Benjamin Franklin
Old Ben Franklin sure knew what he was talking about, even if he wasn't referring to healthcare reform at the time. Preventative care serves a valuable purpose in our health care industry, helping people remain healthy, while diagnosing and treating diseases when they are in their earliest stages. Unfortunately, many Americans let preventative care go by the wayside, particularly if the services come with high co-pays and deductibles that are tough for cash-strapped families to manage today.
One of the most important aspects of healthcare reform is the addition of preventative care services to every health plan at no cost to you. This means that you can get the screenings and immunizations your family needs – without the worry of high co-pays or deductibles to interfere with your monthly budget. The preventative care provision in healthcare reform includes a number of important services that we will cover here.
Covered Preventive Services for Adults
- Abdominal Aortic Aneurysm one-time screening for men of specified ages who have ever smoked
- Alcohol Misuse screening and counseling
- Aspirin use for men and women of certain ages
- Blood Pressure screening for all adults
- Cholesterol screening for adults of certain ages or at higher risk
- Colorectal Cancer screening for adults over 50
- Depression screening for adults
- Type 2 Diabetes screening for adults with high blood pressure
- Diet counseling for adults at higher risk for chronic disease
- HIV screening for all adults at higher risk
- Immunization vaccines for adults--doses, recommended ages, and recommended populations vary:
- Hepatitis A
- Hepatitis B
- Herpes Zoster
- Human Papillomavirus
- Influenza
- Measles, Mumps, Rubella
- Meningococcal
- Pneumococcal
- Tetanus, Diphtheria, Pertussis
- Varicella
- Obesity screening and counseling for all adults
- Sexually Transmitted Infection (STI) prevention counseling for adults at higher risk
- Tobacco Use screening for all adults and cessation interventions for tobacco users
- Syphilis screening for all adults at higher risk
Covered Preventive Services for Women, Including Pregnant Women
- Anemia screening on a routine basis for pregnant women
- Bacteriuria urinary tract or other infection screening for pregnant women
- BRCA counseling about genetic testing for women at higher risk
- Breast Cancer Mammography screenings every 1 to 2 years for women over 40
- Breast Cancer Chemoprevention counseling for women at higher risk
- Breast Feeding interventions to support and promote breast feeding
- Cervical Cancer screening for sexually active women
- Chlamydia Infection screening for younger women and other women at higher risk
- Folic Acid supplements for women who may become pregnant
- Gonorrhea screening for all women at higher risk
- Hepatitis B screening for pregnant women at their first prenatal visit
- Osteoporosis screening for women over age 60 depending on risk factors
- Rh Incompatibility screening for all pregnant women and follow-up testing for women at higher risk
- Tobacco Use screening and interventions for all women, and expanded counseling for pregnant tobacco users
- Syphilis screening for all pregnant women or other women at increased risk
Covered Preventive Services for Children
- Alcohol and Drug Use assessments for adolescents
- Autism screening for children at 18 and 24 months
- Behavioral assessments for children of all ages
- Blood Pressure screening for children
- Cervical Dysplasia screening for sexually active females
- Congenital Hypothyroidism screening for newborns
- Depression screening for adolescents
- Developmental screening for children under age 3, and surveillance throughout childhood
- Dyslipidemia screening for children at higher risk of lipid disorders
- Fluoride Chemoprevention supplements for children without fluoride in their water source
- Gonorrhea preventive medication for the eyes of all newborns
- Hearing screening for all newborns
- Height, Weight and Body Mass Index measurements for children
- Hematocrit or Hemoglobin screening for children
- Hemoglobinopathies or sickle cell screening for newborns
- HIV screening for adolescents at higher risk
- Immunization vaccines for children from birth to age 18 —doses, recommended ages, and recommended populations vary:
- Diphtheria, Tetanus, Pertussis
- Haemophilus influenzae type b
- Hepatitis A
- Hepatitis B
- Human Papillomavirus
- Inactivated Poliovirus
- Influenza
- Measles, Mumps, Rubella
- Meningococcal
- Pneumococcal
- Rotavirus
- Varicella
- Iron supplements for children ages 6 to 12 months at risk for anemia
- Lead screening for children at risk of exposure
- Medical History for all children throughout development
- Obesity screening and counseling
- Oral Health risk assessment for young children
- Phenylketonuria (PKU) screening for this genetic disorder in newborns
- Sexually Transmitted Infection (STI) prevention counseling and screening for adolescents at higher risk
- Tuberculin testing for children at higher risk of tuberculosis
- Vision screening for all children
http://www.healthcare.gov/law/about/provisions/services/lists.html
These services will now be covered through affordable health insurance, without co-pays or deductibles charged to the patient. Now, you don't have any more excuses for not getting your annual mammogram or your flu shot!
What Else do I Need to Know?
The preventative care provision in the healthcare reform went into effect on September 23, 2010. However, insurance companies are not required to abide by the provision until they renew their health plans. For the majority of companies, the new plan year will begin on January 1, 2011. At that time, preventive screenings will be covered in full. If your plan year does not follow the calendar year, talk to your plan administrator about when your preventative care benefits are slated to change.
Some insurance plans may be grandfathered and will not be subject to this provision. Talks are still underway between the White House and insurance lobbyists to determine which plans might be exempt from this provision. If your plan includes a network of providers, you will be required to use a doctor in the network in order to receive your preventative care benefits.
To find out more about what preventative care is included in this provision, talk to your healthcare provider. Questions about specific plan benefits, or whether preventative care is included in your affordable health insurance, should be directed to your plan administrator.
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