How to avoid costly surprises for preventive care

AP News
Posted: Dec 28, 2011 7:24 AM
How to avoid costly surprises for preventive care

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

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_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