New Health Insurance Rules Offer Free Preventive Care

Published: Thu 15 Jul 2010

Thomas Kristoffersen

A number of preventive health services, from colonoscopies to inoculations, is set to be covered with no cost to consumers under the revised insurance rules that are part of the health care reform law.

First lady Michelle Obama, Jill Biden (wife of the vice president), and Health and Human Services Secretary Kathleen Sebelius announced the provisions yesterday afternoon.

Under the new stipulations, those who enroll in a new medical plan on or after September 23, 2010 must receive the preventive care services recommended by the government without any cost-sharing, such as deductibles or co-payments.

The specifics of the provisions were offered at a news teleconference conducted by the White House director of health care reform, Nancy-Ann DeParle, and the president's assistant for special projects, Stephanie Cutter.

"Starting on Sept. 23, all new plans have to cover a comprehensive range of preventive services," recommended by physicians and other medical experts, without any out-of-pocket expenses, DeParle reported.

Covered Preventive Health Care Services

Depending on your health insurance policy and factors like gender and age, preventive medical care is expected to cover services like:

• Shots for pneumonia and flu prevention
• Diabetes, blood pressure, and cholesterol tests
• Counseling, vaccines, and screenings for healthy pregnancies
• Cancer screenings
• Vaccinations for meningitis, measles, HPV, and polio
• Counseling on depression treatments, smoking cessation, reduction of alcohol use, healthy eating, and weight loss
• Mammograms for women over age 40
• Colon cancer screening for adults age 50 and older
• Well-baby and well-child doctor visits up to age 21, in addition to hearing and vision, developmental assessments, and BMI (body mass index) screenings for obesity
• Pap smears for the prevention of cervical cancer

The Effect of Preventive Care

The new rules signal a massive shift in how medical care is regarded, DeParle claims. "We are shifting from health care coverage meaning coverage for the sick to meaning coverage to keep you well."

The goal, she says, is "to create a healthier country."

"Chronic diseases such as heart disease, cancer, diabetes, and others are responsible for seven of 10 deaths among Americans each year and account for 75 percent of the nation's health care spending," Cutter reports.

The co-payments and other out-of-pocket expenses to prevent these maladies are an obstacle, DeParle and Cutter say. For example, Cutter comments, "12 percent of children have not had a doctor's visit within the last year and receive recommended care less than half the time."

Eventually, between now and 2013, the new preventive health care provisions will assist approximately 88 million Americans in getting preventive care, including those in individual and group medical plans, according to estimates from the federal government. Under many bigger employer-sponsored plans, these kinds of medical services have already been covered for a while.