Benefits A-Z: Preventative Health Care

The development and passage of the Affordable Care Act brought the topic of Minimum Essential Care (MEC) into the spotlight. Any major medical health insurance plan or qualified health plan not meeting these minimum essential coverage standards were not allowed to be sold on the state and federal healthcare exchanges, or to be offered as job-based employer health plans. The goal of the ACA and its MEC requirements was to raise the standard of healthcare available to everyone in the US by eliminating health insurance policies that did not cover a bare minimum of health services. Among these bare minimums is preventative health care.

What Types of Services are Included

Under the ACA, most major medical plans must cover a set of preventative services at no cost to the patient. These services include screenings for conditions like diabetes, heart diseases, cancers and sexually transmitted diseases. Gender specific tests include (but not limited to) breast, cervical, and ovarian cancer screenings for women, and prostate screenings for men. Health evaluations for newborns like vision tests and screenings for autism are also included in preventative care. Another service that is included is healthy lifestyle counseling which includes smoking cessation and weight loss counseling. Many people can also get their flu shots and routine vaccinations as part of their preventative health care.

Why the Preventative Health Care MEC Matters

Many services in the preventative care clause were not commonly covered by the low-cost publicly available healthcare plans prevalent before the ACA. This led to many Americans avoiding doctor visits for annual physicals, wellness checkups, and regular screenings. Regular doctor visits help doctors and patients alike detect major health issues which can make treatment more effective. These visits also help patients manage any minor chronic issues.

Preventative Care lowers Healthcare costs

While some people might think that going to a doctor more often will only raise your overall healthcare costs, data proves otherwise. These visits lower lifetime healthcare costs by preventing or managing diseases before they require an emergency room visit or hospital stay. Many of the major causes of death like heart disease or stroke are also some of the most preventable chronic conditions. Early treatment of these conditions help avoid catastrophic medical bills from emergency room visits, bypass surgeries, hospital stays, and lengthy physical therapy. Additionally, the medications required for ongoing treatment of these conditions after a catastrophic episode is far more expensive than the medicine your doctor will prescribe if it is caught early.

If your group needs help navigating medical plans, ACA compliance, or any other employee benefit plans, contact us to speak to a consultant.