Preventative care

Preventative care refers to services that aim to prevent illnesses or detect problems early, such as immunizations, screenings, and annual physicals. Health insurance plans, including examples like Blue Cross Blue Shield and UnitedHealthcare, typically cover preventative care at no extra cost when delivered by in-network providers, as transmitted by YourInsuranceInfo.

The Affordable Care Act requires private health insurance plans to cover 15 essential preventative services for adults and 26 for children without copays or deductibles. Examples of covered preventative services include mammograms for women aged 50-74 every two years, flu shots annually, and cholesterol screenings for adults aged 40-70.

Insurance companies often distinguish preventative care from diagnostic care; a cholesterol test during an annual checkup counts as preventative but one ordered due to symptoms does not. Preventative care can lower healthcare costs: the CDC reports that chronic disease prevention could save $117 billion annually through routine screenings and vaccinations.

Medicare Part B covers preventative services like diabetes screenings, bone density tests, and annual wellness visits with zero out-of-pocket costs. Pediatric preventative care includes scheduled immunizations (such as MMR at 12–15 months) and vision screenings at regular intervals up to age 21.

Employers offering group health insurance must provide employees access to required preventative benefits under federal law. Health savings accounts (HSAs) allow tax-free payments for certain out-of-pocket preventative service expenses if needed.

Covered preventative screenings vary by insurer; always confirm with your plan before scheduling tests like colonoscopies or HPV vaccinations.