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Preventives. Beyond the Physical Exam.

One of the biggest benefits of a high-deductible health plan is that preventive care is covered.

No out-of-pocket payment needed. The example usually cited is the physical, the annual examination by the doctor who is supposed to know us best. It is preventive because our doctor uses this visit as a frame of reference for future conditions. Is there a trend of weight gain? Is there a hint of a heart murmur?

Let’s be honest here. Most of us don’t really have physicals every year. Or even every three. But guess what? You should now. It is covered. And a physical is the best way to keep little health concerns little. That’s the big idea here. Prevention, wellness, early detection. All much better words than treatment and cure. But a word of caution, if you have a symptom, it is not preventive care.

Depending on your plan, the actual services required to administer something like a vaccination may not be covered but the actual shot would be covered.

Here are a few of the procedures that are covered.

Physical

Children

  • Well visits or physical exams up to age 18

  • Immunizations

  • Screenings including vision, hearing, obesity, etc.

  • Drugs: Iron supplements, oral fluoride supplements

Adults

  • Physical exams

  • Immunizations

  • Mammograms

  • Screenings: Colon cancer screening, osteoporosis screening, blood pressure screening, etc.

  • Lab tests that are preventive in nature

  • Prescriptions: Low-dose aspirin, vitamin D supplements, folic acid supplements, contraceptives 

Checklist:

Always review your plan before an appointment. Check to see exactly what is covered. For example, on some plans, the vaccine is covered, but the administration is not.

Confirm with your doctor that your visit is coded as a preventive service.

Every plan is different. You may actually have more services covered on your plan. However, the Affordable Care Act ensures that the services noted above are covered on all plans.