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Regular (Annual) Check-ups

Regular health exams and tests help find problems before they start. When health conditions are found early, your chances for treatment and cure are better. Your age, health, and family history determine which exams and screening you may need, as do your activity level, lifestyle choices and whether you smoke.  According to the Centers for Disease Control and Prevention (CDC), if everyone in the US received the recommended clinical preventive care, we could save over 100,000 lives each year. Preventive health care can help you stay healthier throughout the year.

Preventive Care

Preventive care includes health services like screenings, check-ups, and patient counseling to prevent illnesses, disease, and other health problems, or to detect illness at an early stage when treatment is likely to work best. Getting recommended preventive services and making healthy lifestyle choices are key steps to good health and well-being. Preventive care services are provided when you don’t have any symptoms and haven’t been diagnosed with a health issue connected with the preventive service. They typically are provided during a wellness exam. 
  • Blood Pressure screenings
  • Cholesterol screenings
  • HIV screenings
  • Immunization Vaccines
  • Diabetes (Type 2) screenings
  • Obesity screenings
  • Breast Cancer Mammography (Female)
  • Colorectal Caner (Male)
  • Pap test (Female)
  • Colon Cancer screenings
  • Diet counseling
  • Review your family health history
  • Find out if you are due for any general screenings or vaccinations
  • Write down a list of issues and questions to take with you. It may be hard to remember them, once you are in the exam room.
  • Review any existing health problems
  • Note any changes in your body or health
  • Be honest with your provider

Under the Affordable Care Act, insurance plans cover 100% of many preventive care services at no additional cost to you – when you go to a health care professional in your plan’s network. Members can check their Insurance Summary Plan Description for details about specific screening coverage. Even when your appointment is for preventive care, you may receive other services during the exam that are not preventive. These other services are generally covered under your plan’s medical benefits, not your preventive care benefits. This means you may be responsible for paying a portion or all of the cost, depending on your deductible, copay, and coinsurance amounts.

Preventive vs Diagnostic

Preventive care includes services and tests that are given to detect and prevent a disease when you have no signs or symptoms currently present.

Diagnostic services and test are performed when you doctor feels there may be something wrong based on certain risk factors or your actual symptoms.

Similar services are performed for both preventive and diagnostic reasons.

Here are a few common examples:

Colorectal cancer screening
  • Preventive when recommended to screen for detection of colorectal cancer based on age or family history
  • Diagnostic when recommended as a result of a change in bowel movements
Cervical cancer screening
  • Preventive when recommended to screen for detection of cervical cancer
  • Diagnostic when recommended as a result of pelvic pain
Mammogram screening
  • Preventive when recommended to screen for detection of breast cancer based on age or family history
  • Diagnostic when recommended as a result of a lump in your breast
 This is important to understand because if you discuss risk factors or symptoms you are experiencing during a preventive or wellness visit, your visit may be billed as diagnostic. Ask your physician if you’re not certain.

Source: Centers for Disease Control and Prevention and Humana


Links to various resources on the topics discuss on this page. 

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