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Greater Coverage for Preventive Care Services

2011 marked an important health care milestone. Under the national health reform legislation known as the Affordable Care Act, health plans now offer members full coverage for a variety of preventive care services without having to pay a copayment or co-insurance or meet deductibles.

Preventive care services, such as exams, screenings and immunizations, are a valuable step in your pursuit of health. Prevention is also the best way to avoid illness and save on health care costs. Here are just some of the important health services available to consumers at no additional cost.

For Men

  • Abdominal Aortic Aneurysm one-time screening for men of specified ages who have ever smoked
  • Alcohol misuse screening and counseling
  • Cholesterol screening for men of certain ages or at higher risk
  • Colorectal cancer screening for those older than 50
  • Type 2 diabetes screening for those with high blood pressure
  • Diet counseling for those at higher risk for chronic disease
  • Sexually transmitted infection prevention counseling for those at higher risk
  • Tobacco use screening and cessation interventions for tobacco users

For Women

  • Breast cancer mammography screenings every one to two years for women older than 40
  • Breast cancer chemoprevention counseling for women at higher risk
  • BRCA counseling about genetic testing for women at higher risk
  • Cervical cancer screening for sexually active women
  • Chlamydia infection screening for younger women and other women at higher risk
  • Gonorrhea screening for all women at higher risk
  • Osteoporosis screening for women older than 60, depending on risk factors
  • Tobacco use screening and interventions and expanded counseling for pregnant tobacco users

For Moms-to-Be

  • Anemia screening on a routine basis
  • Bacteriuria urinary tract or other infection screening
  • Interventions to support and promote breastfeeding
  • Folic acid supplements for women who may become pregnant
  • Hepatitis B screening during first prenatal visit
  • Rh incompatibility screening for all pregnant women and follow-up testing for women at higher risk
  • Syphilis screening

For Children

  • Alcohol and drug use assessments for adolescents
  • Autism screening for children at 18 and 24 months
  • Behavioral assessments for children of all ages
  • Developmental screening for children younger than 3 and surveillance throughout childhood
  • Hearing screening for newborns
  • Immunization vaccines from birth to age 18
  • Oral health risk assessment for young children
  • Vision screening

A full list of covered preventive services under the Affordable Care Act is at www.healthcare.gov/law/about/provisions/services/lists.html. Keep in mind that the preventive services provision applies to people enrolled in work-based health plans or individual health insurance policies created after March 23, 2010. These benefits may not be available to individuals enrolled in older plans. You should contact your health plan provider for more details about covered services.

Sebastian is senior medical director of clinical client solutions for Blue Cross and Blue Shield of Florida. She also serves as the medical director lead for the wellness program, Better You From Blue. She has a special interest in wellness programs and is certified by the Wellness Council of America.

Making the Most of an Annual Checkup

A yearly physical is important for everyone who wants to achieve better health overall. But how do you make the most of an annual checkup? Bring a pen!

Study after study points to the role of doctor-patient communication in achieving better patient outcomes and avoiding medical errors. Your doctor will make health and wellness recommendations based in part on what you say about how you live and work. By talking openly and providing the most accurate personal health information, you can ensure that the doctor is able to personalize your care.

To help you in your pursuit of greater health, here is a checklist of information to have in writing before, during and after an annual checkup.

Before

  • List of all the medicines you are taking, including vitamins and herbal supplements
  • Results of any tests taken since your last visit (blood pressure, cholesterol levels)
  • List of questions or concerns, including symptoms you may be experiencing

During

  • Answers to the questions discussed during the checkup; don’t rely on memory
  • Notes on upcoming health screenings based on your age, gender and family history

After

  • Results of tests taken in the office
  • Explanation of new or existing health conditions and where to find more information
  • Clear instructions for taking prescribed medicines

Source: Carmella M. Sebastian, MD

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