Link to list of free preventive services

[ProSense]

Preventive health services for adults

Most health plans must cover a set of preventive services like shots and screening tests at no cost to you. This includes Marketplace private insurance plans.

Preventive care benefits

Preventive care helps you stay healthy. A doctor isn’t someone to see only when you’re sick. Doctors also provide services that help keep you healthy.

Free preventive services

All Marketplace plans and many other plans must cover the following list of preventive services without charging you a copayment or coinsurance. This is true even if you haven’t met your yearly deductible. This applies only when these services are delivered by a network provider.

- more -

https://www.healthcare.gov/what-are-my-preventive-care-benefits

Part 2 at link above:

Preventive health services for women

Most health plans must cover additional preventive health services for women, ensuring a comprehensive set of preventive services like breast cancer screenings to meet women’s unique health care needs.

Comprehensive coverage for women’s preventive care

All Marketplace health plans and many other plans must cover the following list of preventive services for women without charging you a copayment or coinsurance. This is true even if you haven’t met your yearly deductible.

This applies only when these services are delivered by an in-network provider.

- more -

Part 3 at link above:

Preventive health services for children

Most health plans must cover a set of preventive health services for children at no cost when delivered by an in-network provider. This includes Marketplace and Medicaid coverage.

Coverage for children’s preventive health services

All Marketplace health plans and many other plans must cover the following list of preventive services for children without charging you a copayment or coinsurance. This is true even if you haven’t met your yearly deductible.

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FYI:

<...>

We’ve known all along that colonoscopies count as one of the preventive services that insurers must cover without copayment, as they are a screening recommended by the United States Preventive Services Task Force.

What we haven’t known though, was what would happen if, during a colonoscopy, a doctor discovered a polyp and removed it. Would that still count as a screening—or would it cross the line into a treatment that the patient would need to pay for. Harris Meyer raised the issue back in April, writing for the Los Angeles Times:

<...>

Today, the administration resolved this issue: It decided that insurance companies cannot charge patients for the removal of a polyp during a recommended colonoscopy. From an FAQ issued by the Department of Labor:

Q5: If a colonoscopy is scheduled and performed as a screening procedure pursuant to the USPSTF recommendation, is it permissible for a plan or issuer to impose cost-sharing for the cost of a polyp removal during the colonoscopy?
No. Based on clinical practice and comments received from the American College of Gastroenterology, American Gastroenterological Association, American Society of Gastrointestinal Endoscopy, and the Society for Gastroenterology Nurses and Associates, polyp removal is an integral part of a colonoscopy. Accordingly, the plan or issuer may not impose cost-sharing with respect to a polyp removal during a colonoscopy performed as a screening procedure. On the other hand, a plan or issuer may impose cost-sharing for a treatment that is not a recommended preventive service, even if the treatment results from a recommended preventive service.

There it is: Colonoscopy patients will not wake up to a surprise, post-operative bill.

http://www.washingtonpost.com/blogs/wonkblog/wp/2013/02/20/heres-one-way-obamacare-changed-today/

Apply for ACA Exchanges IN PERSON at HRSA Clinics.
http://www.democraticunderground.com/10023826338

Links to download applications
http://www.democraticunderground.com/10023826338#post1

[SwampG8r]

1. k&r good info thanks nt

[ProSense]

8. You're welcome. n/t

[djean111]

2. There it is: Colonoscopy patients will not wake up to a surprise, post-operative bill.

Well, too late for me - had a colonoscopy, the doctor cheerily told me he found a tiny polyp and took it out, after it was biopsied, my puzzled primary care people told me it was just a snip of lining or something, not a polyp, they didn't know why he did that.
I am waiting to see if I get a bill for a surgical procedure - the first time that doctor submitted the bill to Humana Gold, the wrong date was on it for the procedure, so it was not in the approved referral period, go denied. So they will fix that and resubmit, hopefully, but then I might get hit with surgical procedure.

[ScreamingMeemie]

3. If your PCP is saying that, don't pay it. Take it to the mat.

Type up a very nice letter, letting them know (with medical terms) that you know it wasn't a polyp and are willing to fight them.

Odds are, it will disappear... the bill that is.

I've done that 3 times with unnecessary procedures.

[FarCenter]

6. Usually the doctors that do colonoscopies have an interest in the labs that check the tissue

So the doctor increases their income by removing a sample for testing.

[djean111]

7. Thanks to both of you for the replies.

I suppose I should just feel grateful that everything was, um, smooth sailing, but it pisses me off about the non-polyp.
I am a low-carb no-sugar bacon fanatic, so I had been trying to steel myself to the results.
What a nice little racket that would be - and then I read how we seniors are just costing too much money, when we are sometimes victimized by a younger group of people.

[Skidmore]

4. Thank you.

Haven't had much of a chance to check ACA out in depth yet. We've been busy for the last couple of months with my son's wedding. Appreciate the link and other information.

[ProSense]

5. You're welcome, and congratulations! n/t

[Jamaal510]

9. K&R

[Le Taz Hot]

10. If you have to buy into the health plan,

it's not free.

[ProSense]

11. You have to buy into every health plan, including Medicare. Also,

the health care law extended free preventive care to seniors.

[Le Taz Hot]

12. So it's not free.

Your thread title is misleading.

[ProSense]

14. It's free compared to before when you paid into the system and still paid for these services. n/t

[ProdigalJunkMail]

13. does it cover vasectomies???

i think it covers tubal ligation...

sP

[FarCenter]

15. The preventive care for adults appears to be worth $50 / month at the most.

1.Abdominal Aortic Aneurysm one-time screening for men of specified ages who have ever smoked
2.Alcohol Misuse screening and counseling
3.Aspirin use to prevent cardiovascular disease for men and women of certain ages
4.Blood Pressure screening for all adults
5.Cholesterol screening for adults of certain ages or at higher risk
6.Colorectal Cancer screening for adults over 50
7.Depression screening for adults
8.Diabetes (Type 2) screening for adults with high blood pressure
9.Diet counseling for adults at higher risk for chronic disease
10.HIV screening for everyone ages 15 to 65, and other ages at increased risk
11.Immunization vaccines for adults--doses, recommended ages, and recommended populations vary:
•Hepatitis A
•Hepatitis B
•Herpes Zoster
•Human Papillomavirus
•Influenza (Flu Shot)
•Measles, Mumps, Rubella
•Meningococcal
•Pneumococcal
•Tetanus, Diphtheria, Pertussis
•Varicella
12.Obesity screening and counseling for all adults
13.Sexually Transmitted Infection (STI) prevention counseling for adults at higher risk
14.Syphilis screening for all adults at higher risk
15.Tobacco Use screening for all adults and cessation interventions for tobacco users

An aspirin a day is really cheap if you buy the 325 mg generic brands.

There is essentially no benefit for diabetes, tobacco, and alcohol screening because no one stops overeating, drinking or smoking because their doctor advises them to unless they are really sick.

The is very little value in a healthy, asymptomatic person seeing a doctor.

[msanthrope]

16. Excellent post!! nt

[ProSense]

17. Thanks. n/t