Health tip: Understanding preventive care

UnitedHealthcare

Health Tip

Health tip:

Understanding preventive care

Preventive care is routine health care that is meant to help you stay healthy. When you schedule

regular appointments and screenings, it may help you manage and maintain your health.

Preventive care is generally focused on the following

• Evaluating your health when you are symptom-free

• Receiving checkups and screenings

• Decreasing the risk of developing health issues even if you are in the best shape

of your life

Schedule an

appointment with

your doctor today

Understand the difference between preventive care

and diagnostic care

Routine preventive care may

help you manage and maintain

your health, and is generally

covered at 100 percent by most

health plans.

• Preventive care is designed to help you stay healthy, and may be covered by most

health plans with $0 out-of-pocket when you see an in-network provider.

• Costs may be incurred for diagnostic care based on plan coverage. Check your

plan documents for additional details.

Preventive Care Diagnostic Care

Preventive care includes routine well

exams, screenings, and immunizations

intended to prevent or avoid illness or

other health problems.

Diagnostic care includes care or

treatment when you have symptoms or

risk factors and your doctor wants to

diagnose them.

When is care considered preventive?

A procedure can be considered preventive care in some situations, but not in others. This is important, because a service has

to be considered preventive in order to be exempt from copays, coinsurance or deductibles. If it’s not, these charges may apply.

Preventive care example

A woman has an annual wellness exam and receives blood tests to screen for anemia, kidney and liver function, and has a urine

analysis done. If the physician orders lab work during a preventive care visit some of the tests may be covered as preventive

care, such as a cholesterol screening.

continued

Diagnostic care example

However, other blood chemistry panels like an anemia screening in a non-pregnant woman, a kidney or liver function test and

urinalysis, would not be covered as preventive care. The woman would be responsible for any deductible, coinsurance, or

copayment that may be applicable based on her beneﬁt plan.

When a service is performed for preventive screening reasons and is appropriately reported, it will be covered under the

Preventive Care Services beneﬁt. Check your plan documents and consult with your health care provider prior to having the

service performed if you have questions.

Examples of preventive care include

• Routine physical examinations

• Immunizations

• Well baby and well-child care

• Mammography, colonoscopy, sigmoidoscopy

• Cervical screening

Preventive care is important because

• Regular preventive care visits and health screenings may help to identify potential

health risks for early diagnosis and treatment.

• Helping prevent disease and detecting health issues at an early stage is essential to

living a healthier life.

• Following preventive care guidelines —and your doctor’s advice — may help you to stay

healthier. Be sure to discuss speciﬁc health questions and concerns with your doctor.

Find a provider, get plan coverage details and more.

This information is for general informational purposes only and is not intended nor should be construed as medical advice. Individuals should

consult an appropriate medical professional to determine what may be right for them.