Preventive care is well-covered on the Colorado State Exchange health insurance plans, thanks to provisions in the Affordable Care Act (ACA).
When we met David, a 45-year-old software engineer, he had always considered himself healthy and rarely visited the doctor. David came to us during the Open Enrollment Period, and while assisting his review of options we took the time to explain the Colorado preventive care benefits included in his Colorado health plan.
We emphasized that regular check-ups and screenings could catch potential health issues before they became serious. David decided to take advantage of his plan’s Colorado preventive care services. He scheduled a wellness visit and was surprised to find that his cholesterol levels were higher than expected.
With early intervention, David was able to make lifestyle changes and start a treatment plan that significantly improved his health. Whenever we connect, he profusely things us and mentions his regularly utilization of the wellness benefits.
Typical Preventive Care Coverage Includes:
No Cost Sharing with Free Colorado preventive care Services
Colorado State Exchange health insurance plans must cover a set of Preventative services without requiring you to pay a copayment, coinsurance, or meet your deductible. This applies when these services are provided by an in-network provider.
Comprehensive List of Preventive Services:
- Adult Preventative Services: This includes routine physical exams, blood pressure screenings, cholesterol tests, immunizations (e.g., flu shots), and screenings for diseases like diabetes and certain cancers.
- Women’s Preventative Services: These include services such as mammograms, cervical cancer screenings, prenatal care, contraceptives, and breastfeeding support.
- Children’s Preventive Services: Coverage includes regular pediatrician visits, immunizations, developmental screenings, and Preventive dental and vision care for children.
Preventive Service Examples:
- Screenings: Blood pressure, diabetes, cholesterol, certain cancers (e.g., colorectal, breast), and osteoporosis.
- Counseling: For smoking cessation, alcohol use, diet, obesity, and sexually transmitted infections.
- Vaccinations: Routine immunizations for diseases like influenza, hepatitis, and HPV.
- Wellness Visits: Annual physical exams and well-baby/well-child visits.
Access and Network Requirements:
- In-Network Providers: To receive these services at no cost, you typically need to visit healthcare providers within your insurance plan’s network.
- Out-of-Network Providers: Preventative services received from out-of-network providers may not be covered at the same level, so it’s important to verify network participation
Plan Details and Variations:
- State-Specific Requirements: While the ACA sets the baseline for Preventative services, individual states may have additional requirements or variations in coverage.
- Plan Documentation: Review your specific health insurance plan documents or the summary of benefits and coverage (SBC) to understand the exact details of your Preventive care coverage.
Preventive Care with Ongoing Management for Chronic Conditions:
For those with chronic conditions, Preventative care can include additional screenings and management services to help maintain health and prevent complications.
By utilizing the Preventive services covered under your state exchange health insurance plan, you can stay proactive about your health, catch potential health issues early, and ultimately reduce your overall healthcare costs.
Click Here to view an Ian Young Health Insurance video regarding Preventive Services and Cost.
Email Ian Young Health Insurance today or schedule an appointment for assistance getting on a new plan, reviewing your current option, or just making the most of your preventative services for a heathy life.
