Illness Prevention

preventionMany chronic health conditions can be prevented and/or managed better by making healthy choices including:

  • Maintaining a healthy diet
  • Getting Adequate Excersize
  • Reducing Stress
  • Getting Enough Sleep
  • Reducing Unhealthy Habits (i.e.: smoking, excessive alcohol intake, etc.)
  • Always consult with your doctor before starting any exercise program or restrictive diet.
Getting Preventative Care

The Patient Protection Affordable Care Act includes the National Prevention Strategy, a plan that includes actions that public and private partners can take to help Americans stay healthy and fit. Its intention is to help move the nation away from a health care system focused on sickness and disease to one focused on wellness and prevention.

Now Most Prevention Tests Are Covered by Insurance…

If You Have Healthcare Insurance:

The Affordable Care Act contained a provision that allows consumers to access preventive services within their insurance plan at no cost. Insurers are now required to provide certain preventive services to the member/patient without collecting a co-payment, co-insurance or deductible, thus increasing the ability of many people to access life-saving screenings and preventative care. (*Insurance plans that have ‘grandfathered’ status may not be responsible for implementing these provisions).

This will make a big difference for people with Medicare who, like most Americans, tend to use preventive services at roughly half the recommended rate due to not being able to afford the coinsurance/co-pay once charged for these services. For example, only 43 percent of women with Medicare insurance coverage received a mammogram in 2008. Now with the passing of law, out-of- pocket costs on preventative care will be reduced in most instances.¹

Specific preventive services vary depending on your age or gender based on medically recommended and recognized guidelines. (Please see the adjacent column for a full list). Examples of preventative services covered at no cost include but are not limited to, blood pressure screenings, diabetes screening, cholesterol screening tests, many cancer screenings tests, including mammograms and colon cancer screening, counseling on such topics as quitting smoking, losing weight, eating healthy, treating depression, reducing alcohol use, getting routine vaccinations against diseases such as measles, polio, meningitis, flu and pneumonia shots, and vaccines to ensure healthy pregnancies and regular well-baby and well-child visits, from birth to age 21. Medicare covers screening and counseling for obesity to qualified Medicare beneficiaries. You should always refer to your health care certificate of coverage for a detailed description of what is covered, how it is covered, any special providers you must use. Your insurance company must provide you with a copy of your certificate of coverage upon request.

¹(New Release, Affordable Care Act prevention benefits increasing access, lowering costs for people with Medicare, March 16, 2011)

Getting Preventative Tests Covered When You are Not Insured:

uninsured For those patients without insurance, there are resources available to help with covering the cost or reducing the out-of-pocket expenses for receiving certain preventative tests/screenings. Ideally, purchasing insurance would provide the overall coverage necessary should you develop a chronic condition.