Paying family health insurance premiums may seem like a waste of money if your family is healthy. But even for a healthy family, insurance is still important and here's why – the Affordable Care Act (ACA) entitles everyone with an ACA-compliant plan to certain health care services at no out-of-pocket cost, even if your deductible has not been met.
The ACA says that you can get certain preventive care services at no cost to you (if you have an ACA-compliant plan and use in-network health care providers). Different preventive services are covered for men, women and children – a great insurance benefit for families, even healthy families. For example, many routine health care services are included in this benefit, such as many services provided during an annual “Well Woman Visit”. During this visit, specific screenings are provided, depending on the woman’s age. These screenings include –
- Mammograms every two years for women over 40
- Cervical cancer screening
- Osteoporosis screening for women at risk over age 60
However, if other services are provided at during the Well Woman Visit, such as a discussion about a specific medical issue, or a lab test not included in the preventive care list, your insurance company will be billed for that service. That cost may be passed on to you, depending on your specific family insurance plan.
Other services for all adults are covered at no cost, including –
- One-time abdominal aortic aneurysm screening for men
- Diabetes screening for adults with high blood pressure
- HIV screening for those at higher risk
Healthy families with ACA-compliant insurance plans also may get services provided for children at no out-of-pocket cost. Some examples of this are childhood immunizations, lead screenings for kids at high risk, oral, vision and developmental screenings at specific ages and much more. Different types of screenings are provided, depending on the age of the child. Again, if you take your child for a preventive service and ask the physician to treat a specific problem, such as an ear infection, your insurance company will be charged for that non-preventive service.
Depending on your health insurance plan, annual physicals may be covered for your family. If they are not fully covered, certain preventive services within the physical exam itself may be provided at no out-of-pocket cost. You can check this list to see what is “free”.
Access to free and low cost preventive services may help keep your family healthy over time. Browse our healthy family insurance plans in Wisconsin right now. Questions? Talk to our friendly customer service representatives at 800.362.3310.