What Is Preventive Care?
Preventive care includes healthcare services designed to help keep you healthy and identify potential health issues before symptoms appear.
Think of preventive care as routine healthcare that helps you stay well, rather than treatment for an illness or injury.
All available plans include preventive care coverage.
Common Examples of Preventive Care
Preventive care may include services such as:
Annual Wellness Visits
Routine checkups with your healthcare provider to review your overall health and discuss any concerns.
Health Screenings
Screenings help identify potential health conditions before symptoms develop.
Examples include:
- Blood pressure screening
- Cholesterol screening
- Diabetes screening
- Depression screening
- Colorectal cancer screening
Vaccinations
Recommended immunizations for adults and children, including:
- Flu shots
- Tetanus vaccines
- Hepatitis vaccines
- Other age-appropriate immunizations
Women's Preventive Services
Examples may include:
- Well-woman visits
- Mammograms
- Cervical cancer screenings (Pap tests)
- Prenatal preventive screenings
Children's Preventive Services
Examples may include:
- Well-child visits
- Developmental screenings
- Vision screenings
- Hearing screenings
- Childhood immunizations
What Preventive Care Is Not
One of the most common misunderstandings is the difference between preventive care and treatment for a medical condition.
Preventive care is intended to identify health concerns before symptoms appear.
Services received because you are experiencing symptoms, illness, pain, or injury are generally considered diagnostic or treatment services rather than preventive care.
Examples
Usually Considered Preventive Care
✓ Annual physical
✓ Routine wellness visit
✓ Mammogram performed as a preventive screening
✓ Recommended vaccinations
✓ Well-child checkups
Usually Not Considered Preventive Care
✗ Office visit because you have the flu
✗ X-ray for a painful injury
✗ Blood work ordered to investigate symptoms
✗ MRI or CT scan
✗ Follow-up treatment for a diagnosed condition
Why Is This Important When Comparing Plans?
All plans include preventive care coverage.
The biggest differences between plans are typically found in services beyond preventive care, such as:
- Primary care visits
- Specialist visits
- Urgent care
- Prescription drug benefits
- Laboratory services
- X-rays
- Virtual behavioral health services
When comparing plans, it can be helpful to first understand that preventive care is included across all options and then focus on the additional benefits that differ from plan to plan.
Frequently Asked Questions
Is an annual physical considered preventive care?
In most cases, yes. Routine wellness visits are considered preventive care.
Are vaccinations covered as preventive care?
Recommended preventive immunizations are generally included.
If my doctor orders lab work, is it preventive care?
It depends on why the lab work is ordered. Routine preventive screenings may be covered differently than diagnostic testing performed because of symptoms or a medical condition.
If I am sick and visit a doctor, is that preventive care?
No. Visits related to illness, injury, or symptoms are generally not considered preventive care.
Why do all plans include preventive care?
Preventive care is a core benefit included in every available plan and is intended to help members maintain their health through routine screenings, wellness visits, and preventive services.