The Affordable Care Act requires that all insurance plans offer certain preventive care services at no cost to the member, and your employees should be aware of these services. Both the employer and the employee feel the benefit of free health care: There’s no copayment or coinsurance fee, and your workforce’s good health is encouraged. It makes perfect sense to post these free services so your employees will have them top of mind if they want to take advantage of them. Please note that when your employees get preventive services from a doctor in your plan’s network, there is no out of pocket cost. However, if the employee goes out of network, they may have to pay a portion of the costs.
Preventive versus diagnostic care
What’s the difference? Preventive care helps protect you from getting sick. Diagnostic care is used to find the cause of an existing or suspected illness. For example, say your doctor suggests you get a colonoscopy because of your age (when you have no symptoms.) That’s preventive care. On the other hand, say you have symptoms and your doctor suggests a colonoscopy to see what’s causing them. That’s diagnostic care.
Types of care covered beyond annual wellness visit and flu shot
By promoting the free services available, you’re making it clear that you have employees’ well-being in mind. Here are five preventive health measures that ACA-compliant plans cover free of charge:
- Blood pressure screenings. All adults have access to free blood pressure screenings. This is important because high blood pressure may lead to heart attacks, strokes, aneurysms, kidney problems and a whole host of other issues. Sometimes high blood pressure’s underlying cause is unknown, so this is an important health aspect that adults should have checked. Note that many pharmacies and drug stores have free blood pressure monitors that anyone can take advantage of — this may save a trip to the doctor.
- Immunizations for adults and kids. You may think of vaccines mostly as something kids need, but the reality is that adults may also need a booster — or even just an annual flu shot. Some adults were never vaccinated as children for certain conditions, while others may need an additional dose. Immunizations are covered as preventive care, so encourage employees and their families to stay up to date on their needed shots.
- Depression screenings. Depression can affect every area of an employee’s life, and screenings are covered for adults and adolescents under the ACA. Depression is treatable, but that treatment requires a diagnosis. You don’t need to pry into an employee’s private life; just make it known that depression coverage is available as a free preventive measure.
- Cancer screenings. Not all cancer screenings are covered, but encourage your workforce to take advantage of those that are available. For instance, colorectal screenings are covered for everyone over 50, and women can get screened for cervical and breast cancer.
- Developmental screenings for children. It’s hard for parents to know what’s normal and what’s not in child development, and it’s also important to catch problems early. Developmental screenings are covered up to age three, and behavioral assessments are covered until the age of 18.
These are just a few of the preventive care options covered for free under ACA health plans. To utilize any of these services, call your primary care doctor or your children’s pediatrician and schedule an appointment. Visit HealthCare.gov for a comprehensive list of free preventive services that most health plans must cover, and make this information widely known and accessible to your employees.
This content is provided solely for informational purposes. It is not intended as and does not constitute legal advice. The information contained herein should not be relied upon or used as a substitute for consultation with legal, accounting, tax and/or other professional advisers.
Suzanne Lucas spent 10 years in corporate human resources, where she interviewed and hired employees, managed the numbers, and double-checked with the lawyers. Her writings have appeared in Inc. Magazine, CBS MoneyWatch, US News, Readers Digest and other publications. She focuses on helping businesses nurture great employees and helping employees enjoy great careers.