What is preventive care?
Sometimes called preventative care, a preventive care visit is an annual check-up that your health care provider performs to screen for, and potentially prevent, future sickness and disease. Preventive care often helps identify potential health conditions early, so any needed treatment is easier and costs are less.
How do I know if my preventive visit is free?
Wellmark plans cover at least one preventive exam at no cost to you each plan year. Coverage for additional preventive services will vary by plan — check your Summary of Benefits and Coverage (SBC) for more details. Some plans require you to see the health care provider you've chosen as your primary care provider for preventive exams to be covered at 100 percent. Before making an appointment, be sure to check if you've already used your preventive care benefits by logging in to myWellmark® and viewing the Benefits Used section at the bottom of the Coverage page.
What types of services are covered at a preventive visit?
Wellmark has outlined a list of common preventive services that are covered under the Affordable Care Act (ACA). However, it’s always important to check your coverage in myWellmark before your visit. Here are a few common preventive care screenings and visits:
- Annual adult wellness examination
- Annual well-child visits
- Cancer screenings (Colorectal, Breast, Cervical)
- Depression screening
- High blood pressure screening
- Immunizations
What’s the difference between preventive care and diagnostic care?
Generally, care is considered preventive if your visit isn’t related to a specific medical condition or symptom you’re experiencing. Talk with your provider to learn more. If you get care related to a specific issue you’re experiencing, you may have a cost share — such as a copay or coinsurance — related to an exam or procedure you need because of that issue.
For example, if you bring up a symptom during your preventive visit that requires additional conversation or a follow-up exam or procedure, those additional services may be categorized as diagnostic. This could lead to a copay or coinsurance.