FREE preventative services under the Affordable Care Act (Obamacare)

03/14/2016

Did you know you that you can receive FREE preventative services based on your age and sex? Most people don’t realize that plans they receive under the Affordable Care Act allow them free yearly preventative services. Don’t miss out on your “FREEBIE.”

What I’ve run into over the last 3 months (and I wish I had a dollar for every phone conversation I’ve had with people) where I’ve told everyone who called with a question about a plan on the exchange I told them that no matter which plan they select every person covered under it is entitled to preventative services based on their age and sex.  These preventative services are not counted against their deductible and for the most part all a person owes is the office co-pay amount.  What I’ve found out 2 years ago is that people who picked from the exchange were not taking advantage of their preventative visits because most of them didn’t realize it was a “freebie”.

I explain that when they call to schedule an appointment to use the words “I’d like to schedule my preventative visit”; this way the appointment get’s off on the right foot – I also explain that during the appointment they have to refrain from saying things like “ hey doc, while I’m here would you take a look at my toe”…. I tell them that if the doctor examines their toe (or whatever) and discovers something he/she has to document that on the medical record and now when coding the visit their preventative visit changes to that of a problem focused visit and they’ve more or less “flushed their preventative visit benefit down the toilet”.

While it’s good to bring things to the doctors attention, if the doctor thinks there is something concerning your toe it’s better to then say, “you know doc, maybe I should make a separate appointment I don’t want to lose my preventative visit benefits.”   I also talk about mammograms & colonoscopy’s and how they can go from screening to diagnostic.  Always encouraging patients to seek medical attention but to do it in a way that maximizes their benefits.

I also tell them to ask their insurance exactly what is included as “preventative” in their plan and is it every 12 months or once a calendar year.  The average length of these calls is about 30 minutes and everyone I’ve talked to has thanked me over and over again because no one tells them these things.  It may be in the insurance brochure but most people do not understand it very well.

Here’s a link to the governments list of preventive services as covered under the Affordable Care Act – and I “believe” under group health as well.  Medicare has its own rules and so does Medicaid.

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