Many people don’t realize that their health insurance covers certain preventive services at 100% when received from an in-network provider. These services can help detect health problems early when they’re easier to treat or prevent issues from developing in the first place. The key is understanding which services are covered and making sure you’re getting care from an in-network provider. Below, we’ll break down some common preventive care services that are often covered by health insurance at no additional cost to you.
What is Preventive Care?
Preventive care includes services like screenings, vaccinations, and counseling designed to help you stay healthy. When these services are covered by your insurance, you don’t have to worry about paying a copay, coinsurance, or deductible, as long as you see an in-network provider.
Common Preventive Services Covered by Health Insurance
Here are some examples of preventive services that are typically covered at 100% by most health insurance plans:
- Routine Screenings
Regular screenings can detect health problems before they become serious. Common screenings include:- Blood pressure checks
- Cholesterol screenings
- Diabetes screenings
- Cancer screenings (mammograms, colorectal screenings, cervical cancer screenings)
- Depression screenings
- Immunizations
Vaccines are vital in preventing the spread of serious diseases. Health plans usually cover:- COVID-19
- Flu
- Tetanus, Diphtheria, and Pertussis (Tdap)
- Measles, Mumps, and Rubella (MMR)
- Hepatitis A and B
- Human Papillomavirus (HPV)
- Chickenpox (Varicella)
- Shingles (Herpes Zoster)
- Well-Woman and Prenatal Care
Women’s health is a key part of preventive care. Covered services often include:- Cervical cancer screenings (Pap smears)
- Mammograms
- Prenatal screenings and counseling
- Birth control methods (with options for contraception covered at no cost)
- Well-Child Visits
For children, preventive care includes routine checkups and vaccinations, ensuring they grow healthy and strong. This often covers:- Newborn screenings
- Routine eye and hearing exams
- Vaccinations as recommended by the CDC
- Tobacco and Alcohol Counseling
Preventive care can also include behavioral counseling to help reduce health risks such as smoking or excessive alcohol use. - Diet and Obesity Counseling
If you’re at risk for heart disease or other conditions, your insurance may cover counseling to help with diet, exercise, and maintaining a healthy lifestyle.
Important Notes
While these preventive services are typically covered at no cost, it’s important to note that they must be provided by an in-network provider. Services provided out-of-network could result in additional costs such as deductibles or coinsurance. Additionally, services may no longer be considered preventive if they’re related to a specific medical condition, in which case regular cost-sharing may apply.
Stay Informed
Preventive care is one of the best ways to protect your health. Be sure to review your health insurance policy to see which services are covered at 100%. If you’re unsure, contacting your insurance provider can give you clarity about your coverage and help you maximize the benefits available to you.