Free Screening: Your ADA Rights to No-Cost Preventive Care

Did you know that there are many screenings and preventive care measures that you can get for no cost? 

In 2010, the ADA made many preventive care measures cost-free: no co-pay, cost-splitting, or out-of-pocket from all subject insurers including employer-provided healthcare and Medicare. The trick is getting access and making sure every free screening is documented in the no-cost way.

If you are looking to prevent known health problems, age-related concerns, and remain safe in the face of exposure to illness, know your rights. You can and should claim your no-cost preventive care whenever and wherever it is most relevant to your life and well-being. Today, we’re talking about your ADA rights to free screenings, and how to get them.

No-Cost Preventive Care – How Does It Work?

Under the Affordable Care Act, or ADA, a wide selection of approved preventive care costs have been deemed no-cost-splitting in the patient’s favor. This means that you will not be asked to absorb a co-pay or out-of-pocket. Instead, these procedures will be billed as fully covered by your insurance (free to you) as long as you access the preventive services on the recommended schedule.

What Preventive Care Can You Get For Free?

The exact policies of your fully-covered screenings and preventive medicine depend on your insurer. Insurers may only cover generic preventive medicines and the rules may apply or be implemented slightly differently per provider. Very common restrictions include both age (screenings after a certain age when risk increases) and frequency (you can only get screened every X months or Y years.)

Generally, however, the ACA has defined 22 broad categories of preventive treatments that should be comped for adults, 27 preventive measures for women specifically, and 29 preventive treatments for children. Know your coverage and ask specifically about no-cost screenings and preventive treatments that may be available.

While most preventive measures are screenings, some preventive medicines taken in pre-risk situations (ex: a job with AIDS exposure risk) should also be included.

Make Sure Your Screenings are Marked as Preventive

Insurance companies don’t prefer full coverage, it dips into their revenue. So watch out for instances where supposed-to-be free screenings are billed as diagnostic instead. This can occur for a number of reasons, and you often won’t be told the difference. You may be billed for a diagnostic if your doctor recommended the screening, if you have a history of what you’re being screened for, or even if the billing minion finds a detail in your family history that could suggest higher risk. 

That’s right, if you are getting preventive screening for something you have a higher chance of getting, some insurers will try to bill you as if it’s not preventive medicine. The fine-line syndrome doesn’t stop there.

Some are billed if their tests find anything. Some are billed for their routine screening if the last screening detected something. Keep an eye on your insurance policies and your billing statements.

Claim Your No-Cost Screenings and Preventive Care

If you receive your health insurance from an ACA subject provider, be sure to claim your free preventive procedures. Get your screenings at the recommended ages and talk to your doctor about any preventive care you may benefit from without being aware of it.

Investigate the preventive care policies of your specific insurer, the screenings covered, and when or how often these screenings are free. Do the same for your family if they are on the plan, and encourage friends to get screened on their own insurance policies.

Screenings catch things like cancer and deteriorating conditions early, save lives, and  – though they hate to admit it – also save insurers millions on avoided care.

Healthcare Solutions Team is a wholly-owned subsidiary of the Allstate Insurance Company, so rest assured you’re getting quality service.