What to know about insurance for preventive screenings

19 hours ago

In the United States, most health insurance plans cover preventive health screenings and services at no cost. However, the services may only be free if a healthcare professional under the plan's network provides them.Terms and conditions for individual health insurance plans can vary, so people should always check with their insurance provider to see which services are covered and if any fees will apply.This article explores which preventive screenings insurance plans cover, whether there are any fees for preventive screenings, and whether Medicare covers them.The use of binary terms such as 'male' and 'female' or 'men' and 'women' in this article reflects the language of the sources we've used. Unless otherwise noted, it's unclear whether the research we reference included participants with expansive gender identities.Preventive screenings for all adultsMany health insurance plans will cover the following types of preventive services without charging people a copayment or coinsurance:Preventive screenings for all adults include:blood pressure screeningdepression screeningalcohol misuse screening and counselingobesity screening and counselingcertain vaccinations, depending on a person's age and other factorscholesterol screening, depending on a person's age and other factorstype 2 diabetes screening for anyone between 40 to 70 years of age with overweight or obesitydiet counseling for adults at higher risk for chronic diseasetuberculosis screening for certain people without symptoms who are at high riskaspirin use to prevent cardiovascular disease and colorectal cancer for anyone between 50 to 59 years of age with a high cardiovascular riskstatin preventive medication for certain adults ages 40 to 75 yearscolorectal cancer screening for people between 45 to 75 years of agelung cancer screening for adults ages 50 to 80 at high risk for lung cancer due to current smoking or after quitting smoking in the past 15 yearstobacco use screening for everyone and quitting interventions for people who use tobaccofalls prevention for adults ages 65 years and over who live in a community settinghepatitis B screening for people at high riskhepatitis C screening for people between the ages of 18 to 79 yearssexually transmitted infection (STI) prevention counseling for individuals at higher risksyphilis screening for adults at higher riskHIV screening for anyone ages 15 to 65, and other ages at increased riskpreexposure prophylaxis (PrEP) HIV prevention medication for individuals at high risk of contracting HIV through sex or injection drug useFor menAdditionally, most health insurance plans should cover abdominal aortic aneurysm one-time screening for men of specified ages who have ever smoked without charging them a copayment or coinsurance.Preventive screenings for womenMany health insurance plans should also cover the following types of preventive services for women without charging them a copayment or coinsurance:Cervical cancer screening, which includes Pap tests for individuals ages 21 to 65.Breast cancer screening mammogram, with or without clinical breast examination, every 1 to 2 years for individuals ages 40 and older.Breast cancer chemoprevention counseling for individuals at higher risk.Breast cancer genetic test counseling for those at higher risk.Domestic and interpersonal violence screening and counseling. Yearly urinary incontinence screening.Diabetes screening for people with a history of gestational diabetes who are not currently pregnant and who have not been diagnosed with type 2 diabetes.Chlamydia screening for younger individuals and those at higher risk.Gonorrhea screening for people at higher risk.Bone density screening for individuals over age 65 or 64 years and younger who have experienced menopause.Yearly healthcare professional visits to get recommended services.Preventive screenings for people who are pregnant or may become pregnantFor people who are pregnant or may become pregnant, many health insurance plans will also cover the following types of preventive services without charging a copayment or coinsurance:birth controlsyphilis screeningurinary tract or other infection screeningfolic acid supplements for individuals who may become pregnanthepatitis B screening for pregnant people at their first prenatal visitgestational diabetes screening for people who are 24 weeks pregnant or later and those at high risk of developing gestational diabetespreeclampsia prevention and screening for pregnant people with high blood pressureRh incompatibility screening for all pregnant people and follow-up testing for individuals at higher riskbreastfeeding support and counseling from trained providers, and access to breastfeeding supplies, for people who are pregnant or nursingpostpartum depression screening for birthing parents at baby doctor visitsexpanded tobacco intervention and counseling for pregnant people who use tobaccoPreventive screenings for childrenMost health insurance plans should also cover the following types of preventive services for children and infants without charging a copayment or coinsurance:blood screening for newbornshearing screening for all newborns, and regular screenings for children and adolescents, as a healthcare professional recommendshemoglobinopathies or sickle cell screening for newbornsbilirubin concentration screening for newbornsphenylketonuria screening for newbornsgonorrhea preventive medication for the eyes of all newbornshypothyroidism screening for newbornsautism screening for children at 18 and 24 monthsoral health risk assessment for young children from ages 6 months to 6 yearsfluoride varnish for all infants and children as soon as teeth are presentfluoride supplements for children without fluoride in their water sourcedevelopmental screening for children under age 3regular height, weight, and body mass index (BMI) measurements for all childrenregular baby and child doctor visitsbehavioral assessments for all childrenvision screening for all childrenhematocrit or hemoglobin screening for all childrendyslipidemia screening for all children once between 9 and 11 years and once between 17 and 21 years, and for children at higher risk of lipid disorderslead screening for children at risk of lead exposuretuberculin testing for children at higher risk of tuberculosisAre there any fees for preventive screenings?Preventive screenings are usually only free of charge if a healthcare professional in the plan's network provides them.Healthcare insurance providers may charge a fee if a person receives preventive services from an out-of-network provider. They may also charge a fee for some doctor's office visit costs if preventive service is not the main purpose of the visit.Additionally, a person's insurance may not cover preventive services if a person has a 'grandfathered' health insurance plan.People should always check the terms and conditions for their individual health insurance plan or contact their insurance provider for more information.Individuals without health insurance may still be able to access free or reduced-cost preventive screenings through options like Medicaid, community health centers, or charity clinics. »Learn more:What medical care is available without insurance?Does Medicare cover preventive screenings?Medicare Part B covers many preventive screening tests if a person meets certain criteria. Many of these services are free of charge, but people should always check the terms and conditions of their individual Medicare plan for more information, as plan benefits can vary.For example, someone with a Medicare Advantage Plan may have access to certain preventive services that Original Medicare does not cover, and their costs and coverage rules may differ.Medicare resourcesFor more resources to help guide you through the complex world of medical insurance, visit our Medicare hub.When to speak with a doctorPeople should aim to attend any preventive screenings that are recommended based on their age or other factors, such as pregnancy or tobacco use.Anyone who is unsure about which preventive services would benefit them may want to contact a healthcare professional for further information.»FIND CARE:Find a healthcare professional in your area today.SummaryMost health insurance plans cover preventive health screenings and services at no extra cost.However, coverage and fees can differ between plans. For example, insurance providers may charge a fee if a person receives preventive services from an out-of-network provider. A person should always check the terms and conditions of their health insurance plan or contact their provider for more information.People who do not have health insurance may want to explore options such as Medicaid, community health centers, or charity clinics.

Hashtags

Health

#preventive screenings

#healthcare professional

Try Our AI Features

Explore what Daily8 AI can do for you:

Comments

No comments yet...

Texas judge dismisses Humana's challenge to Medicare plan ratings

Reuters

31 minutes ago

Reuters

Texas judge dismisses Humana's challenge to Medicare plan ratings

July 18 (Reuters) - A Texas federal judge dismissed a lawsuit brought by health insurer Humana (HUM.N), opens new tab challenging the U.S. government's reduction in its star ratings for government-backed Medicare plans. The ruling, which may hit the government's bonuses to Humana next year, dragged shares nearly 3% lower in morning trading. Shares of other insurers, including UnitedHealth (UNH.N), opens new tab and Centene (CNC.N), opens new tab, were also down between 1.5% and 2.3%. The judge dismissed the lawsuit against the Department of Health and Human Services after finding that Humana had failed to exhaust all of its out-of-court options to challenge the ratings. The U.S. Centers for Medicare and Medicaid Services (CMS) issues star ratings, from one to five stars, for private insurers' Medicare Advantage plans to help beneficiaries choose their plans. Plans with higher star ratings also receive higher payments from the government if they keep costs below certain targets. In its lawsuit, Humana had challenged what it called the federal government's "arbitrary and capricious actions" in administering the Medicare Advantage and Part D Star Ratings program. The company had sought administrative reconsideration of its 2026 Quality Bonus Payment determination for twenty-nine contracts. Humana is one of the largest providers of Medicare Advantage plans in the U.S., which are funded by the Medicare health insurance program for seniors and some disabled people but administered by private insurers.

What you should know before travelling with any medication

The Independent

an hour ago

The Independent

What you should know before travelling with any medication

As summer holidays begin, many travellers are packing more than just swimsuits and sunscreen – for millions, medicines are essential. But taking them abroad isn't always simple. From legal pitfalls to temperature-sensitive drugs, here's how to travel safely and legally with your medication. Know the law Medicines that are legal in the UK can be restricted or even banned in other countries. Having a valid prescription doesn't guarantee you can take a medicine into another country. For example, Nurofen Plus, which contains codeine (an opioid painkiller), is prohibited in countries like Egypt, Indonesia and the UAE. Even common cold remedies containing decongestants like pseudoephedrine can land you in trouble in places like Japan and South Korea. This is because pseudoephedrine can be used to make methamphetamine ('speed'). Likewise, many stimulant ADHD drugs are also banned from these countries. Some countries have restrictions on the amount of medication that you are allowed to bring into the country, usually a maximum of a three-month supply. Travellers often overlook how strict customs regulations can be regarding medications. Even if prescribed for a valid medical reason, carrying a prohibited drug can lead to confiscation (leaving you without essential treatment), fines (especially in countries with tough drug laws) and detention or arrest in rare but serious cases. If you're travelling with certain controlled drugs – such as opioids, stimulants or psychotropic substances – you may need to apply for an export licence from the UK Home Office. This is typically required when carrying a supply of three months or more. Examples of controlled drugs include diazepam (for anxiety and muscle spasms), codeine and morphine (for pain), amphetamines (for ADHD) and temazepam (for insomnia). Before you travel, check whether your medicine is affected by any of these restrictions. Use the country's embassy website or the UK government's travel advice to check the rules of your destination country. This should provide guidance on whether you simply need a copy of your prescription, a doctor's letter or a special import certificate (some countries require official documentation even for personal use). The UK government advises carrying controlled drugs or any drugs that might be restricted in your hand luggage. You should take along a prescription or a signed letter from your doctor detailing your medication, dosage and travel dates. Ensure you take sufficient supplies for the duration of your trip and include extras for unexpected delays, damage or loss. Store your medication properly It might be tempting to save space by transferring pills or liquids into smaller containers or pill organisers. While this can be convenient, it's not always advisable. Customs officials may not recognise unlabelled containers, increasing the chance of delays or confiscation. Some medications are sensitive to light, air or temperature, and must remain in their original packaging to stay effective. For example, HRT (hormone replacement therapy) sprays like Lenzetto must not be decanted. These products rely on precise metered dosing and specialised packaging to deliver the correct amount of hormone. Transferring them to another container could result in incorrect dosing or loss of potency. Similarly, GTN (glyceryl trinitrate) tablets, used to treat angina, should always be stored in their original glass bottle. The active ingredient can evaporate if exposed to air, reducing the tablets' effectiveness. You might be worried about the 100ml liquid in hand luggage restriction – with a doctor's letter certifying the need for this medicine, you should be able to take larger amounts of liquid medicine through security. Medicines should always be kept in their original packaging with labels intact. When in doubt, ask your pharmacist whether your medication can be safely repackaged for travel. It's also important to split your supply of medicines between bags (if more than one is used) in case one is lost. Tablets and capsules can sometimes be placed in a pill organiser for daily use, but always carry the original box or prescription label as backup. Some medicines require refrigeration – like Wegovy and Ozempic (semaglutide) injections for weight loss or insulin. Usually, unopened Wegovy pens and insulin preparations should be stored between 2°C and 8°C in a fridge. Once out of the fridge, they can be kept at room temperature (up to 25°C) for up to 28 days, but must be protected from heat and sunlight. High temperatures, such as in direct sunlight or a hot car, can damage insulin. When travelling, use an insulated travel case or cool pack, but avoid placing pens or other medicines directly next to ice packs to prevent freezing. Airlines generally do not provide refrigeration or freezer storage for passenger items, including medicines, due to space and liability concerns, but it's worth contacting them to see if they can help with arrangements for storage. Inspect insulin for crystals after flying – if any are present, it should be discarded. You can bring needles and injectable medicines like EpiPens (for allergies), insulin or Wegovy in your hand luggage. But it's important to carry a doctor's note stating your medical condition and the necessity of the medication, and a copy of your prescription. You should also declare them at airport security. Security officers may inspect these items separately, so allow for extra time going through security. Contact your airline for any specific rules on needles and injectable medicines. Always carry such medicines and medical devices in your hand luggage – checked bags can be lost or exposed to extreme temperatures. Don't skip doses Tempting as it may be to leave your medication behind for a short trip, doing so can be risky. Stopping treatment – even temporarily – can lead to relapse or worsening of symptoms (especially for chronic conditions like diabetes, hypertension or depression). For medicines like antidepressants or opioids, people may start feeling withdrawal effects. You're also at risk of reduced effectiveness if you miss doses of medicines that require consistent levels in your bloodstream. If you're considering a break from your medication, consult your doctor first. They can advise whether a short pause is safe or help you plan a travel-friendly regimen. Take the right documents While showing your NHS app to border officials may help demonstrate that a medicine is prescribed to you, it's not always sufficient, especially when travelling with restricted or controlled drugs and injectable medicines. Most countries require a copy of your prescription and a doctor's letter confirming the medication is for personal use. Your doctor is not legally obliged to issue this letter, but most will do so upon request. It's best to ask at least one to two weeks in advance, as some practices may charge a fee or require time to prepare the documentation. Travelling with medication doesn't have to be stressful, but it does require planning. With the right preparation, you can enjoy your holiday without compromising your health or running afoul of foreign laws.

Texas judge dismisses Humana challenge to Medicare plan ratings

Reuters

an hour ago

Reuters

Texas judge dismisses Humana challenge to Medicare plan ratings

July 18 (Reuters) - A Texas federal judge dismissed a lawsuit brought by health insurer Humana (HUM.N), opens new tab challenging the U.S. Department of Health and Human Services' reduction in its star ratings for government-funded Medicare plans. Humana filed the lawsuit in September 2023 in the Northern District of Texas against the U.S. Department of Health and Human Services and former Health Secretary Xavier Becerra.