Preventive services

Protecting and promoting your health year round

We want to support and encourage your efforts to protect and promote you and your family’s greatest asset, your health. Many preventive healthcare services, including screenings, checkups, and counseling, cost you nothing.

Here are some examples of preventive services that could cost you nothing:

  • “Shots” for children to protect them against diseases
  • Mammograms every 1 to 2 years for women age 40 and older
  • Flu shots
*These services are free only when delivered by a doctor or other provider in your plan’s network.

What are preventive screenings?

Preventive screenings are intended to identify diseases or medical 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 identified as being at risk for a specific disease or medical condition by a preventive screening. Preventive counseling and intervention 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 diagnosed but who have been identified to be at risk for a specific disease or medical condition.

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 diagnostic 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, ask him/her:

  • What is this test for?
  • Why do I need this treatment?
  • Are there any alternatives?
  • What are the possible complications?
  • When you bill Health Options, is this service considered preventive or diagnostic?
  • Is this additional service billed as part of my preventive visit or is it considered a diagnostic service?
You can access a full list of preventive services online at HealthCare.Gov/Coverage/Preventive-Care-Benefits/