Preventive Care Services and the Affordable Care Act
What preventive health services will and will not be covered under the Affordable Care Act
Dr. Bruce Hensel
Preventative tests and treatments will now be covered by the Affordable Care Act, at no cost to the member. Dr. Bruce Hensel reports for NBC4 News at 5 p.m. on Sept. 16, 2013.
The Affordable Care Act, also known as “Obamacare,” goes into effect on Jan. 1, 2014.
Beginning Oct. 1, you will be able to purchase health insurance through the California’s health exchange called Covered California. If you have a current health plan, you can keep it or you purchase a new one from either Covered California or directly from an insurance provider.
No matter how you purchase your insurance, beginning Jan. 1, your policy will cover more than 60 preventive tests and treatments as required by the Affordable Care Act.
“All preventative services that are approved or have strong scientific evidence must be covered by insurers at no cost to the member," said Dr. Gerald Kominski, director of UCLA’s Center for Health Policy Research.
The rationale for paying for those services is that it is less expensive to prevent disease than to treat disease. More importantly, these simple treatments could save your life; at the very least they can help you live well and vibrantly.
A preventive service will be covered by insurance if studies have shown it to be accurate and cost effective. That means that certain tests, such as Prostate Specific Antigen or PSA, which is used to screen for prostate cancer, will not be covered because there are questions about its accuracy.
Treadmill “stress” tests, which may detect otherwise silent heart disease, may be covered for some people but not for others; coverage will depend on family, personal history and condition.
The same is true for the breast and ovarian cancer genes known as BRCA1 and 2. In those cases, you will need documentation from your doctor in order to get the tests for free. For most of the other preventive services, that won’t be necessary.