Some of the first benefits that the American public received under the Affordable Care Act went into effect on September 23, 2010. The Affordable Care Act required that all major medical health insurance policies that went into effect on that day or afterward had to cover certain preventative services. In addition, these preventative and/or wellness services could not have any cost-sharing. No cost sharing simply means no out-of-pocket payments and no need to wait until you reach a deductible.
However, there is a lot of confusion regarding these “Annual Preventative Care” visits or Annual Wellness visits (what used to be known as the “Annual Physical”) and what is included.
We want to work together to make sure that when you call in and schedule your Annual Preventative/Wellness visit that you understand what that means.
This is Preventative Care: Medical treatment for specific health conditions, on-going care, lab or other tests necessary to manage or treat a medical issue or health condition are considered diagnostic care or treatment, not preventive care.
The following list of screenings are/may be available during the Preventative/Wellness visit. Some of these screenings can be yearly, while others are one-time screenings. For more detailed information you should contact your insurance carrier.
Preventive care benefits for adults
- Abdominal aortic aneurysm one-time screening for men of specified ages who have ever smoked
- Alchohol misuse screening and counseling
- Asprin use to prevent cardiovascular disease for men and women of certain ages
- Blood pressure screening
- Cholesterol screening for adults of certain ages or at higher risk
- Colorectal cancer screening for adults over 50
- Depression screening
- Diabetes (Type 2) screening for adults with high blood pressure
- Diet counseling for adults at higher risk for chronic disease
- Hepatitis B screening for people at high risk, including people from countries with 2% or more hepatitis B prevalence, and U.S.-born people not vaccinated as infants and with at least one parent born in a region with 8% or more Hepatitis B Prevalence
- Hepatitis C screening for adults at increased risk, and one time for everyone born 1945-1965
- HIV screening for everyone ages 15-65, and other ages at increased risk
- Immunization vaccines for adults- doses, recommended ages, and recommended populations vary
- Lung cancer screen for adults 55-80 at high risk for lung cancer because they’re heavy smokers or have quit in the past 15 years
- Obesity screening and counseling
- Sexually transmitted infection (STI) prevention counseling for adults at higher risk
- Syphilis screening for adults at higher risk
- Tobacco Use screening for adults and cessation interventions for tobacco users
Preventative care benefits for children
- Alcohol and drug use assessments for adolescents
- Autism screening for children at 18 and 24 months
- Behavioral assessments for children ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15-17 years
- Blood pressure screening for children ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years
- Cervical dysplasia screening for sexually active females
- Depression screening for adolescents
Annual Preventative Care Visit: The Basics
The physical exam is an essential part of any doctor’s visit. Surprisingly, though, there are no absolutes in a routine physical. A good doctor may be thorough or brief, but he or she will spend time listening to your concerns and providing counseling for your particular needs.
Annual Preventative Care Visits usually check your:
This is your chance to mention any complaints or concerns about your health. Your doctor will also likely quiz you about lifestyle behaviors such smoking, excessive alcohol use, sexual health, diet, and exercise. The doctor will also check on your vaccination status and update your personal and family medical history.
Vital Signs. These are some vital signs checked at your visit:
- Blood pressure: Less than 120 over 80 is a normal blood pressure. Doctors define high blood pressure (hypertension) as 140 over 90 or higher.
- Heart rate: Values between 60 and 100 are considered normal. Many healthy people have heart rates slower than 60, however.
- Respiration rate: From 12 to 16 breaths per minute is normal for a healthy adult. Breathing more than 20 times per minute can suggest heart or lung problems.
- Temperature: 98.6 degrees Fahrenheit is the average, but healthy people can have resting temperatures slightly higher or lower.
- General Appearance: Your doctor gathers a large amount of information about you and your health just by watching and talking to you. How is your memory and mental quickness? Does your skin appear healthy? Can you easily stand and walk?
- Heart Exam: Listening to your heart with a stethoscope, a doctor might detect an irregular heartbeat, a heart murmur, or other clues to heart disease.
- Lung Exam: Using a stethoscope, a doctor listens for crackles, wheezes, or decreased breath sounds. These and other sounds are clues to the presence of heart or lung disease.
Make an appointment to discuss your preexisting conditions and medications please call and schedule a follow up appointment with your Primary Care Provider.