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Preventive and Wellness Services

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Increasing access to preventive care for Minnesotans

Health reform makes it easier for Minnesotans to stay healthy.  If you are enrolled in employer health coverage or a health insurance plan that was created after March 23, 2010, you can now receive certain preventive services at no cost.  Depending on your age, this includes blood pressure, cholesterol, diabetes, depression, cancer screenings and more.  Beginning in 2014, all health insurance plans must provide these screenings at no cost to you.

Minnesotans on Medicare also have more access to preventive care under health reform.   Medicare Part B now covers screenings for diabetes, cholesterol and more, at no cost to the person covered by Medicare.   New Medicare enrollees also receive a “Welcome to Medicare” physical within the first year of coverage.  After that, Medicare will cover an annual wellness exam to create and update a personalized prevention plan.

Beginning in 2012, women will also have better access to preventive services.  Starting with plan years beginning on or after August 1, 2012, women will receive screenings and counseling for domestic violence and approved contraceptives at no cost.   Women may also receive screenings for Human Papillomavirus (HPV) and well women visits at no cost, depending on age.

Will preventive services be covered under my health plan?

If you are enrolled in employer health coverage or a health insurance plan that was created after March 23, 2010, preventive services are covered at no cost to you. In 2014, all plans will cover preventive services, including those purchased on the Minnesota exchanges.  Please note that the health plan is only required to cover preventive services at 100 percent if you are using an approved, in-network provider.   Also, if the preventive service is not the primary reason for your doctor’s visit, you may be charged some of the cost of the visit.  If you have questions, it’s always best  to check with your employer or insurance carrier directly to confirm.

What services are considered “preventive services”?

Depending on your age and health plan, you may receive the following preventive services at no cost to you. For a full list of preventive services, visit healthcare.gov.

• Blood pressure, cholesterol and diabetes screenings
• Cancer screenings, including mammograms and colonoscopies
• Counseling on such topics as quitting smoking, losing weight, eating healthfully, treating depression and reducing alcohol use
• Routine vaccinations against diseases such as measles, hepatitis or meningitis
• Flu and pneumonia shots
• Counseling, screening, and vaccines to ensure healthy pregnancies
• Regular well-baby and well-child visits, from birth to age 21

Will I still receive a Welcome to Medicare exam under health reform?

Medicare will continue to cover a Welcome to Medicare physical exam when Medicare coverage begins. This free exam is available during the first 12 months of Medicare enrollment and has no deductibles or copayments.  However, those who are new to Medicare cannot get both the Welcome to Medicare exam and the annual wellness visit during the first 12 months of enrollment.  The annual wellness visit takes place each year after that.

Do the requirements to cover preventive services change for Medicare Advantage plans?

Most Medicare Advantage plans already offer Medicare-covered preventive care services with no deductibles or copayments.  Health reform does not require these plans to offer preventive care services free of charge.  If you have a Medicare Advantage plan, please check with your plan to find out whether there may be deductibles and copayments for preventive care services.