Patients are tapping into health law's free preventive services (NE and IA)

[Omaha Steve]

http://www.omaha.com/article/20120805/LIVEWELL03/708059914/1685#patients-are-tapping-into-health-law-s-free-preventive-services

By Bob Glissmann
WORLD-HERALD STAFF WRITER

If Linda Shepard had scheduled a colonoscopy screening two years ago, the deductible would have cost her up to $1,000.

Her colonoscopy set for later this month won't cost her anything out-of-pocket.

Shepard, 65, recently learned about the preventive services available under her company's insurance policy. She figured she should get the screening before she retires and “just as well have it paid for.”

Shepard, of Blair, Neb., is among thousands of Nebraskans plugging into the preventive services that insurers must fully cover under the federal Patient Protection and Affordable Care Act.

FULL story at link.

Covered preventive services for adults*



» Abdominal aortic aneurysm: one-time screening for some men who have smoked

» Alcohol misuse: screening and counseling

» Aspirin use: discussion for men and women of certain ages

» Blood pressure screening

» Cholesterol screening: for adults of certain ages or at higher risk

» Colorectal cancer screening: for adults over 50

» Depression screening

» Type 2 diabetes screening: for adults with high blood pressure

» Diet counseling: for adults at higher risk for chronic disease

» HIV screening: for higher-risk adults

» Sexually transmitted infection prevention counseling: for adults at higher risk

» Immunization vaccines for adults (recommended populations vary): Hepatitis A; Hepatitis B; Herpes zoster (shingles); Human papillomavirus; Influenza (flu shot); Measles, mumps, rubella; Meningococcal; Pneumococcal; Tetanus, diphtheria, pertussis; Varicella (chickenpox)

» Obesity screening and counseling

» Tobacco use screening for all adults and cessation interventions for tobacco users

» Syphilis screening for higher-risk adults

*Other services for women and children are listed at www.healthcare.gov

Source: U.S. Department of Health and Human Services


Most cost-effective preventive services

The Partnership for Prevention, a nonpartisan organization of business, nonprofit and government leaders, used a ranking system combining cost and effectiveness. The maximum score any service could receive is a 10. All are covered under the health care law.

10

» Discuss daily aspirin use (men 40+, women 50+)

» Childhood immunizations

» Smoking cessation advice and help

9

» Alcohol screening and counseling

8

» Colorectal cancer screening (50+)

» Hypertension screening and treatment (18+)

» Influenza immunizations (50+)

» Vision screening (65+)

7

» Cervical cancer screening (women)

» Cholesterol screening and treatment (men 35+, women 45+)

» Pneumococcal immunizations (65+)

6

» Breast cancer screening (women 40+)

» Chlamydia screening (sexually active women under 25)

» Discuss calcium supplementation (women)

» Vision screening (preschool children)

5

» Discuss folic acid use (women of childbearing age)

» Obesity screening (adults)

4

» Depression screening (adults)

» Hearing screening (adults 65+)

» Injury prevention counseling (parents of children ages 0-4)

» Osteoporosis screening (women 65+)

2

» Cholesterol screening (high-risk men under 35, women under 45)

» Diabetes screening (adults at risk)

» Diet counseling (adults at risk)

» Tetanus-diphtheria booster (adults)

Source: Partnership for Prevention's National Commission on Prevention Priorities

[leftstreet]

1. How is it 'free?' Is this the public option?

Oh wait, I see. This is about policy and regulation changes for insurers and their customers

[veganlush]

2. we should avoid calling it "free"

before these changes, you had to dutifully pay your premiums then if you needed a test or something, you paid for much or all of THAT too through co-pays and deductibles, etc. This isn't getting something free now, it's getting the insurance coverage we pay for. Referring to it as free we just further fuel the right-wing meme (false) that people are getting something for nothing at the expense of tax payers

[BlueStreak]

4. Goood point

We should simply point out that EVERYBODY benefits by focusing on wellness. it si obviously good for patients to catch conditions early. But it is also good for the insurance companies. If they can catch colon cancer in its early stages, that is much cheaper to treat and the costs are much more predictable (much less risk for the insurance company).

We should point out that, while the insurance companies complained about some aspects of the PPACA law, you did not hear insurance companies complaining about covering preventive care. It is good for them as long as all their competitors have to do the same thing.

The new law greatly reduces the incentives to play "musical chairs", trying to push your sick patients onto your competitors. It focuses on wellness, which lowers everybody's costs, making insurance more affordable. It mandates minimum standards, so your competitor can't don a bait-and-switch to lure away your customers with a stripped-down policy. And it virtually guarantees a nice profit for any insurance company that can handle claims efficiently.

Insurance companies won't admit this publicly, but this law is really good for them.

I am in the process of applying for a policy to replace my COBRA coverage, now that the SCOTUS matter has been settled. My Anthem agent was almost giddy talking about how "every one of our policies now covers preventive services with no deductible." I didn't want to argue with him that that's the law. I just enjoyed hearing a guy who was proud to be representing a company and product that does the right thing (even if it took a new law to force them.)

[veganlush]

6. exactly. very well stated!

[etherealtruth]

3. Thank you for posting this

Though I have health insurance through "work" ... my premiums are high, as are my co-pays and deductibles. I have avoided seeking many of these screenings simply because these screening were cost prohibitive for me.

[taught_me_patience]

5. Patients are also abusing "preventative" visits

to avoid paying a co-pay. My wife is repeately asked to code for a "physical" so that patients don't have to pay a co-pay even when the visit is not a physical.

[Motown_Johnny]

7. don't they/we only get 1 of those, without a copay, per year?

And if so, they why is that a problem?

[Motown_Johnny]

8. Thanks for this post, do you have a link for those covered services

that are without a copay?

I started giving Aflac money a couple of months ago. If I had a comprehensive list of services available without a copay I could map out a better plan for having myself checked out and then having Aflac reimburse me for having been checked out.

I know no company's business model is to pay out more than they take in but I hope to be proactive enough to have a reasonable amount of my premiums reimbursed by keeping up on these tests.