Preventive care is crucial for staying healthy and ensuring any medical condition is detected and treated early. In this blog, we discuss what is and is not considered preventive healthcare and if health insurance covers it.
What Is Preventive Care?
Simply put, preventive healthcare encompasses services offered to stay healthy and avoid getting sick. A lot of the time, when an illness or medical condition is detected early, the treatment is more successful.
A common question is, “Why should I see a doctor if I’m not sick?” Well, preventive care, more specifically annual checkups, can lower your healthcare costs by detecting any illnesses early on, preventing you from paying for treatments, etc.
Preventive Health Examples
There are many examples of preventive care, including the following:
- Annual Checkups: These are essential for detecting health problems and discussing any health concerns. These visits may often include general health screenings for high blood pressure, cholesterol, sexually transmitted infections, and more depending on your lifestyle and habits.
- Cancer Screenings: Most people don’t experience cancer symptoms early on in their most treatable stages. That’s why cancer screenings are recommended at certain times throughout your life. For women, preventative screenings include Pap tests and mammograms. For men, screening for prostate cancer is also recommended.
- Childhood & Adult Immunizations: Believe it or not, immunizations are considered preventive care. This includes childhood immunizations such as hepatitis A and B, chickenpox, measles, and MMR (mumps and rubella). For adults, this includes boosters for Tdap as well as other immunizations for shingles, etc.
- Yearly Flu & COVID-19 Shots: Flu and COVID-19 shots not only reduce the risk of getting the flu or COVID-19, but they can significantly reduce the chances of serious symptoms, making these shots preventive care.
What Is Not Considered Preventive Care?
Preventive care services are performed before a problem is identified, but if an issue is found, any treatment after is not considered preventive. For example, if a patient gets a colonoscopy as a part of their annual checkup, that’s preventive. If additional follow-up care is needed, such as a procedure to remove growths or cancer treatments, it is not considered preventive. In this case, there may be out-of-pocket costs.
Non-preventive Care Examples
- Primary care visits related to specific healthcare issues such as the common cold, minor injuries, seasonal allergies, etc.
- Appointments with specialty doctors like dermatologists, allergists, and more (depending on your coverage)
- Diagnostic tests/screenings to learn more about a suspected or known medical condition
If you are unsure whether or not a service is considered preventive, contact your insurance company to double-check.
Does Health Insurance Cover It?
Most preventive healthcare services are already included in your health insurance cost, so you won’t pay extra. Actually, most health plans are required by law to cover 100% of eligible services. So, as long as you receive preventive care services from a doctor covered by your plan, you’re typically off the hook for paying co-pays or deductibles.
GEA Is Here To Help
In the case that a preventive care service detects a medical condition and further care is needed, GEA is here to help pick up out-of-pocket costs. Our TRICARE and CHAMPVA Supplemental Insurance plans are designed to wrap around your current TRICARE or CHAMPVA plans. They can help reduce or eliminate out-of-pocket costs your primary plan doesn’t, such as prescription medications, co-pays, doctor visits, and more. Visit our website to learn more.
Because when you’re diagnosed with a medical condition, the last thing on your mind should be healthcare costs.
