What Is Preventive Care and Do Health Plans Cover the Cost?

Preventive services are health care services like annual checkups, vaccinations, counseling, and screenings to detect and prevent illnesses and diseases.

Having access to preventive care is important to stay healthy and receive necessary treatment when needed.

Taking necessary steps to receive recommended preventive care can also help reduce overall medical expenses. Many preventive screenings and tests are designed to catch a disease before it has a chance to start. Catching a condition in its early stages and receiving treatment can help prevent even more invasive and expensive treatments in the future.

Check out healthcare.gov for a complete list of covered preventive services.

Preventive care and health coverage plans

With Allstate Benefits group health plans, employers and employees won't have to worry about having the coverage they need for ACA-recommended preventive care.

Preventive care coverage that is included with all Allstate Benefits group health plan designs align with Affordable Care Act requirements and the U.S. Preventive Services Task Force (USPSTF) A & B recommendations.

Finding and receiving preventive care

When seeking preventive care, it's important to understand how health plans work and know how to seek covered health care.

Using the resources members receive during enrollment is key to receiving covered preventive care.

Always check to make sure providers are in-network or, if the plan doesn't use a network, reach out to member services if you need help finding a provider.

For example, colorectal cancer screenings are recommended for adults ages 45 to 75 years old by the U.S. Preventive Services Task Force (USPSTF) as an A and B recommendation.

Check plan resources to see if the plan uses a network. If it does use a network, use the network's resources to find an in-network provider that will perform the service. A lot of networks have online search tools to help members filter providers by service and location so patients can easily find a convenient, in-network provider.

If the plan does not use a network, typically the plan has a customer service line members can call for assistance.

The Core Value reference-based pricing plan through Allstate Benefits doesn't use a network. Members can use any provider that accepts the plan. If members need assistance finding a provider, they have a couple of options:

1. Call the Member Advocacy Program (MAP) team. The MAP team is there to help plan members find providers that accept their health plan, understand how to use their benefits, and more.
2. Check out Healthcare Bluebook™. Healthcare Bluebook is a navigation tool to help members access quality health care at a fair price. With this easy-to-use service, plan members can shop around online for low-cost, high-quality providers.

Final thoughts

When it comes to covered preventive care by the ACA, it's important to understand that age, conditions, and annual limits apply for group health plans.

For example, plans typically only cover one well visit every year. That's why it's important to check with your health plan provider to see what's covered and what services members are eligible for.

Regular preventive care is an important step to a healthy life and we're here to help keep you on that path.

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