WHAT IS CONSIDERED “PREVENTATIVE”
BY HEALTH INSURERS?
Jeffrey A. Forrest, Co-Founder of Prevention on Purpose
THANKS TO A KEY PROVISION IN
THE AFFORDABLE CARE ACT
Most health insurers have now
adopted a policy of covering
preventati...
THE RESEARCH
IS SIMPLY
UNDENIABLE:
Evidence-based preventative services can
improve health in that they can identify
illne...
THIS IS GREAT NEWS!
Considering a large portion of us weren’t even
getting the healthcare we need simply because of
cost.
NOW THAT
PROCEDURES SUCH
AS WELLNESS
CHECKUPS,
SCREENINGS, AND
VACCINATIONS ARE
FREE OF COST
…it’s important to know just
...
KNOW THE LAW… ALL OF IT
➤ The Affordable Care Act covers wellness exams, vaccinations,
cancer and other health screenings,...
IT’S BEST TO BECOME FAMILIAR WITH
YOUR INSURANCE PLAN, AS WELL
➤ While private insurance providers are
required to follow ...
MAKE YOUR INTENTIONS
CLEAR…
When you go in for a preventative check up or
screening, make that clear when you’re making th...
…TO DEAL WITH
POSSIBLE BILLING
ISSUES LATER
Pay careful attention to any bills received after
going in for a preventative ...
TAKING THE STEPS TO UNDERSTAND BOTH THE PROVISIONS OF THE
AFFORDABLE CARE ACT, AS WELL AS THE INTRICACIES OF YOUR
INSURANC...
TO LEARN MORE ABOUT
PREVENTATIVE HEALTH,
VISIT…
http://jeffreyaforrest.org
Preventative Health Services--What Your Insurance Covers
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Preventative Health Services--What Your Insurance Covers

Jeffrey A. Forrest, co-founder of Prevention on Purpose, is an advocate for preventative health care. With the adopted of the Affordable Care Act, insurance providers are now required to cover preventative health services in full. However, knowing what, exactly, is covered is key, so you don't end up with a hefty bill!
Published on: Mar 4, 2016
Published in: Healthcare      
Source: www.slideshare.net


Transcripts - Preventative Health Services--What Your Insurance Covers

  • 1. WHAT IS CONSIDERED “PREVENTATIVE” BY HEALTH INSURERS? Jeffrey A. Forrest, Co-Founder of Prevention on Purpose
  • 2. THANKS TO A KEY PROVISION IN THE AFFORDABLE CARE ACT Most health insurers have now adopted a policy of covering preventative health care in full Section 2713 requires private health plans to provide coverage for a variety of preventative services without imposing cost- sharing This includes copayments, deductibles, and co-insurance
  • 3. THE RESEARCH IS SIMPLY UNDENIABLE: Evidence-based preventative services can improve health in that they can identify illnesses earlier, provide more effective management, and overall lower costs of health when treating a condition that could have potentially developed into something more complicated and dangerous
  • 4. THIS IS GREAT NEWS! Considering a large portion of us weren’t even getting the healthcare we need simply because of cost.
  • 5. NOW THAT PROCEDURES SUCH AS WELLNESS CHECKUPS, SCREENINGS, AND VACCINATIONS ARE FREE OF COST …it’s important to know just what–exactly–is covered.
  • 6. KNOW THE LAW… ALL OF IT ➤ The Affordable Care Act covers wellness exams, vaccinations, cancer and other health screenings, as well as FDA-approved contraceptives, entirely in most cases. ➤ However, health plans that were already in place when the ACA took effect on March 23rd, 2010, are not required to fall into compliance with this provision of the law, as those health plans are considered to be “granfathered.” ➤ Pay attention to the details. While some services are deemed preventative procedures, there may be a metaphorical “fine print” you need to pay attention to. For example, colonoscopies are considered a preventative service that is covered in full under the ACA, if you are over the age of 50.
  • 7. IT’S BEST TO BECOME FAMILIAR WITH YOUR INSURANCE PLAN, AS WELL ➤ While private insurance providers are required to follow the provisions of the ACA, they are granted some wiggle room when it comes to interpreting medical guidelines, and they will use it. ➤ Become familiar with where your insurance puts their metaphorical foot down. ➤ For example, while insurers are required to cover all forms of FDA- approved birth control pills, it doesn’t mean they are required to offer every pill offered, and often will only provide generic types. ➤ Also, it’s wise to stay within the network of your plan in order to make the preventative service cost-free, as seeking service from a doctor outside of your network will cost you.
  • 8. MAKE YOUR INTENTIONS CLEAR… When you go in for a preventative check up or screening, make that clear when you’re making the appointment. If an existing health issue is brought up during the same visit, chances are you could get billed for it despite the preventative service being free of cost.
  • 9. …TO DEAL WITH POSSIBLE BILLING ISSUES LATER Pay careful attention to any bills received after going in for a preventative service. If you’re getting charged for something you think you shouldn’t, question it, as often it’s a simple billing error that requires a phone call to remind billing your visit was for preventative purposes. If that doesn’t work as seamlessly, contact your insurer, as often they will be able to step in on your behalf and resolve the issue. If you feel like you’re jumping through hurdles dealing with the billings department and your insurer, there is an option for you to file an appeal with your health plan. While it may seem tedious, health care is a human right, and affordable health care is required to us by law.
  • 10. TAKING THE STEPS TO UNDERSTAND BOTH THE PROVISIONS OF THE AFFORDABLE CARE ACT, AS WELL AS THE INTRICACIES OF YOUR INSURANCE PLAN WILL ONLY BRING CLARITY TO THE CONTROL YOU HAVE OVER YOUR OWN HEALTH AND WHAT YOU CAN DO IN ORDER TO MAKE SURE YOU’RE LIVING THE BEST LIFE POSSIBLE.
  • 11. TO LEARN MORE ABOUT PREVENTATIVE HEALTH, VISIT… http://jeffreyaforrest.org

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