How to avoid costly surprises for preventive care
Posted: Wednesday, January 4, 2012 8:04 pm
By The Associated Press
Experts offer the following tips for avoiding surprise medical bills for preventive care:
• Call your insurance plan — the 800-number on the back of your insurance card — to find out whether the plan must comply with the Affordable Care Act. If your plan is “grandfathered,” it’s exempt from the law’s requirement to pay for preventive care.
• When scheduling an appointment or talking with your doctor, clarify that you’re coming in for a covered preventive service and you don’t expect to be charged. The doctor must be in your health plan’s network.
• If you’re hit with an unexpected bill, call the doctor’s office and ask how the bill was submitted. Was it submitted as a preventive care service?
• Complain to your state’s insurance department if you believe you’ve been billed in error.
The following is a partial list of services that should be covered without copays or other cost-sharing by the patient:
• Alcohol misuse screening and counseling
• Aspirin use for men and women of certain ages
• Blood pressure screening for all adults
• Cholesterol screening for adults of certain ages or at higher risk
• Colorectal cancer screening for adults, starting at age 50
• Depression screening for adults
• Type 2 diabetes screening for adults with high blood pressure
• Diet counseling for adults at higher risk for chronic disease
• HIV screening for all adults at higher risk
• Flu shots and other recommended vaccines for adults and children
• Obesity screening and counseling for adults and children
• Tobacco use screening for all adults and cessation interventions for tobacco users
• Breast cancer mammography screenings every 1 to 2 years for women over 40
• Cervical cancer screening for sexually active women
• Folic acid supplements for women who may become pregnant
• Osteoporosis screening for women over age 60 depending on risk factors
• Autism screening for children at 18 and 24 months
• Depression screening for adolescents
• Fluoride supplements for children without fluoride in their water source
• Hearing screening for all newborns
Sources: U.S. Department of Health and Human Services; Georgetown University Health Policy Institute
Published in The Messenger 1.4.12