Flu, COVID and RSV Vaccinations Are Free When Obtained In-Network. What Other Preventive Care Could You Be Getting at No Cost?
It’s no secret that doctor visits can be expensive, but if your visit includes one of the more than 100 services considered “preventive” by the U.S. government (e.g., a flu or COVID vaccination) and that service is rendered by a network provider, that service will be free of charge.
What are Preventive Care Services?
Preventive care services are medical services that have been proven to help people avoid chronic and acute illness. The Affordable Care Act mandates insurance plans, like the Health Plan, cover these services at 100% of the cost when administered by a network provider. The United States Preventive Services Task Force, a panel of experts in disease prevention and medicine, recommends which services should be on the U.S. preventive care list. As required by the Affordable Care Act, the Health Plan adds these services to its preventive care list within a year of the task force’s recommendation.
The current preventive care list covers a range of services for all ages, including the following:
- Flu and COVID vaccinations;
- RSV vaccinations for adolescents ages 19 and under, adults aged 60+ and pregnant women
- Newborn hearing screening;
- Breast cancer mammography every two years for women aged 50 to 74 years;
- Colorectal cancer screening for adults ages 45 to 75, once every 10 years;
- Autism screening for children at 18 and 24 months; and
- Blood pressure screening for adults.
Taking advantage of preventive care services can benefit both your health and wallet. For example, the Centers for Disease Control and Prevention (CDC) notes that if the majority of U.S. adults were to follow the guidance recommended for colorectal cancer screening, deaths from the disease could be reduced by as much as 33% by 2030.
Improve Your Health and Keep Track of the Recommended Preventive Care Services
Below are some tips to follow to enhance your health and ensure you are following the recommended guidelines:
- When seeking preventive care, make an appointment for your desired preventive services with a network provider; and
- Keep a calendar or journal that documents when your preventive services were last completed and when it is recommended you complete them again.
Keep in mind preventive services that are not within the required guidelines or provided by a non-network provider will not be paid at 100%. For questions about the timing of preventive services or your potential costs, contact the Health Plan’s Participant Services Department at 323-866-2200, Ext. 401.
Takeaways
Following the recommended guidelines for preventive care services can help you enhance and maintain your health. Flu and COVID vaccinations, health screenings and many other preventive services are provided at no cost to you when administered by a network provider. Familiarize yourself with the full list of free preventive care services available to you by visiting www.dgaplans.org/preventivecare.
