Bcbs Preventative Care Handout: Your Path to Better Health and Lower Costs

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Taking charge of your health is one of the best decisions you'll ever make. By understanding what BCBS preventative care handout has to offer, you can take proactive steps towards a healthier, happier you.

BCBS preventative care handout is designed to help you stay on top of your health, with a range of services and screenings to catch potential issues early. This can lead to better health outcomes and lower costs in the long run.

Some preventative services covered by BCBS include routine check-ups, vaccinations, and screenings for conditions like diabetes and high blood pressure. These services are usually free or low-cost, making them a valuable resource for anyone looking to prioritize their health.

By taking advantage of BCBS preventative care handout, you can identify and address health concerns before they become major issues. This can lead to a significant reduction in healthcare costs and a better quality of life.

Preventative Care Services

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Preventative care services are an essential part of maintaining good health. These services are covered at no extra cost for members of non-grandfathered individual health insurance plans, and may also be available to employees who get benefits from their employer.

Preventative care services include routine health checkups, routine gynecological visits, and certain lab tests. They also include annual mental health wellness exams, immunizations for you and your family, and cancer screenings including colorectal cancer screenings and mammograms.

Some examples of preventative care services include:

  • Routine health checkups
  • Routine gynecological visits
  • Certain lab tests
  • Annual mental health wellness exams
  • Immunizations for you and your family
  • Cancer screenings including colorectal cancer screenings and mammograms
  • Depression screenings
  • Obesity screenings
  • Tobacco or alcohol use evaluations

Preventative care services are not the same as diagnostic services. Diagnostic services are ordered by your primary care provider (PCP) when you have symptoms of an illness or risk factors that might indicate a health problem. These services may include tests such as lipid panels, complete blood count (CBC), blood sugar (A1C), and thyroid-stimulating hormone.

The Affordable Care Act (ACA) requires most health insurance plans to provide coverage without cost sharing for certain recommended preventive services. This includes screenings for women's health, such as mammograms and cervical cancer screenings.

Reduce Healthcare Costs

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You can reduce healthcare costs by taking advantage of preventive care services. Preventive care is routine health care that includes screenings, checkups, and patient counseling to help prevent illnesses, disease, and other health problems.

To avoid extra costs, it's essential to know what qualifies as preventive care. Check your Benefit Booklet for details on other preventive care benefits.

You can also ask your doctor questions to avoid surprising costs. When you schedule an appointment, ask for preventive care screenings and tests that are 100% covered by your plan.

Here are some questions to ask your doctor:

  • Are the tests or treatments done during my appointment considered preventive care?
  • Will discussing other health problems that are not considered preventive care during my appointment lead to extra costs?
  • Can lab work be sent to a Blue Cross NC in-network lab?

By asking these questions, you can avoid extra costs and stay on top of your health. The Affordable Care Act (ACA) also requires most health insurance plans to provide coverage without cost sharing for certain recommended preventive services.

Understanding Your Policy

The Affordable Care Act, also known as the Patient Protection and Affordable Care Act (PPACA), made significant changes to the healthcare system, including the expansion of preventive services.

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Preventive services, such as routine check-ups and screenings, are now covered without copays or coinsurance under most plans, thanks to the Affordable Care Act.

These services include routine services like annual physicals, vaccinations, and screenings for various health conditions, which can help prevent illnesses and detect health problems early on.

Policy:

Your policy requires non-grandfathered plans to cover "Recommended Preventive Services" for plan/policy years beginning on or after September 23, 2010, when rendered by an in-network provider.

These services include evidence-based services with a current "A" or "B" rating from the United States Preventive Services Task Force, immunizations recommended for routine use by the Advisory Committee on Immunization Practices at the Centers for Disease Control and Prevention, and child preventive care and screenings provided for in the guidelines supported by the Health Resources and Services Administration.

The preventive services coverage requirements apply to the following general categories of preventive services: Evidence-based services with a current “A” or “B” rating from the United States Preventive Services Task ForceImmunizations recommended for routine use by the Advisory Committee on Immunization Practices at the Centers for Disease Control and Prevention (children, adolescent, and adult)li>Child preventive care and screenings provided for in the guidelines supported by the Health Resources and Services Administration (HRSA)For women, the preventive care and screenings provided for guidelines under development by the U.S. Department of Health and Human Services (HHS)

The patient’s medical record must contain clear documentation of the nature of the preventive service provided.

Non-grandfathered plans are not required to provide coverage for the recommended preventive services when they are delivered by out-of-network providers.

CPT Codes

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CPT Codes are crucial for billing services correctly, and one important modifier to know is Modifier 33, which is used for preventive services.

Modifier 33 is used when the primary purpose of the service is to deliver an evidence-based service in accordance with a US Preventive Services Task Force A or B rating.

The correct coding for both ICD-10 and CPT or HCPC's code is also required, as listed in the coding instructions of the Preventive Care Services document.

Preventive services mandates, whether legislative or regulatory, can also be billed with Modifier 33.

For Women

For women, it's essential to stay on top of preventive care services. The Health Resources and Services Administration (HRSA) supports guidelines for women's health, including screening for urinary incontinence, which should be done annually.

Screening for urinary incontinence involves assessing whether women experience incontinence and whether it impacts their daily activities and quality of life. If indicated, women should be referred for further evaluation and treatment.

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The Women's Preventive Services Initiative recommends screening women for urinary incontinence annually. This can be a crucial step in maintaining overall health and well-being.

Cancer screenings are also vital for women. Mammograms for breast cancer and colorectal cancer screenings are essential for early detection. Different types of colorectal cancer screenings are available, including at-home tests that can be mailed directly to individuals.

According to the Patient Protection and Affordable Care Act (ACA), preventive care services for women are supported by the Health Resources and Services Administration. This includes preventive care and screening for women supported by HRSA.

Here are some key points to keep in mind:

  • Preventive care and screening for women supported by HRSA includes services such as screening for urinary incontinence and cancer screenings.
  • Cancer screenings can detect cancer early, which is essential for treatment and recovery.
  • Preventive care services for women may vary depending on health history and age.

Affordable Care Act and Prevention

The Affordable Care Act has made a significant impact on preventive care services, ensuring that many essential services are covered at no cost to you. The law requires most health insurance plans to provide coverage without cost sharing for certain recommended preventive services.

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Preventive care services include screenings for infants, children, and adolescents, as well as women's health services such as mammograms and prenatal care. These services are covered under the Affordable Care Act, and you won't be charged a copayment, coinsurance, or deductible if you visit a network provider.

If you're unsure what services are covered, you can refer to the Healthcare Reform Preventive Care Services Coding document for the latest information. This document outlines the specific services that are covered under the Affordable Care Act.

Some examples of preventive services that are covered at 100% include:

  • Aspirin
  • Certain supplements
  • Tobacco cessation support
  • Some contraceptives

These services are included on the Affordable Care Act Preventive Drug List, which you can refer to for more information. By taking advantage of these covered services, you can stay on top of your health and catch any potential issues early on.

Frequently Asked Questions

What are the four major categories of preventative care?

Preventative care is categorized into four main areas: screenings and counseling, routine immunizations, and services for women, children, and youth

What is covered under a preventive visit?

During a preventive visit, you can expect coverage for routine health checks, screenings, and counseling services to help prevent or manage chronic conditions and promote overall well-being. This may include tests for blood pressure, diabetes, and cholesterol, as well as cancer screenings and guidance on healthy habits.

What does preventive care 100% mean?

Preventive care at 100% means you pay nothing out-of-pocket for covered services, but not all medical screenings qualify. Learn what specific services are considered preventive and covered under health reform.

Sheldon Kuphal

Writer

Sheldon Kuphal is a seasoned writer with a keen insight into the world of high net worth individuals and their financial endeavors. With a strong background in researching and analyzing complex financial topics, Sheldon has established himself as a trusted voice in the industry. His areas of expertise include Family Offices, Investment Management, and Private Wealth Management, where he has written extensively on the latest trends, strategies, and best practices.

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