Essential Spotlight


Understanding and


Accessing Preventive Services: A Key Component of a Healthy Lifestyle


services, which include many shots and screening tests, are only  


M A list of covered preventive services for all adults, for women


 Marketplace website at https://www.healthcare.gov/coverage/ 


Some common examples of preventive healthcare services include: • Colorectal screening


• Mammograms every 1 to 2 years for women age 40 and older • Flu shots and select immunizations What are preventive screenings?


Preventive screenings are intended to identify diseases or medi- cal conditions before any signs or symptoms are present. Preventive screenings enable early diagnosis of potential health problems. They do not include tests or services to monitor or manage a condition or disease once it has been diagnosed.


What is preventive counseling?


Preventive counseling usually occurs when a person has been - tion by a preventive screening. Preventive counseling and inter- vention is intended to provide you with basic information about a medical condition and help you develop the skills to manage your health. Preventive counseling applies to people who have not been  disease or medical condition.


ost health plans, including those that are available on the Health Insurance Marketplace, are required to cover a set of preventive services at no cost. The free preventive


What is the difference between diagnostic services and preventive services?


A diagnostic service is used to diagnose a condition or monitor an existing condition when you have some risk factors or symptoms. Diagnostic services help your provider diagnose your illness and talk with you about the best course of treatment. Sometimes diag- nostic services will involve tests also used as preventive services, but these services won't be considered preventive if they are part of a visit to diagnose a new condition, monitor an existing condition or treat an illness or injury.


If your provider recommends a service or test, you may want to ask him/her: • What is this test for?


• Why do I need this treatment? • Are there any alternatives? • What are the possible complications?


• Is this additional service billed as part of my preventive visit or is it considered a diagnostic service?


• When you bill my insurance company, is this service considered preventive or diagnostic?


Be sure to check your health plan documents or contact  health services will be covered. Preventive services will help you to avoid or detect health problems and are an important component of a healthy lifestyle.


About Community Health Options:


 insurance plan providing comprehensive health insurance ben-  - tive partnerships with Members, businesses, and a broad network of providers. Many Health Options Members serve on the Board of  management and development of the products and services. For more information, visit www.healthoptions.org.


8 ELM™ Maine - July/August 2018


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