Understanding preventive care

When shopping for a health plan, understanding preventive care coverage is essential. Here are some of the top questions people often have.

What is preventive care?

Preventive care includes routine health services like annual physical exams, vaccinations, and screenings for conditions such as cancer, diabetes, and osteoporosis.

Why is preventive care important?

Preventive care plays a crucial role in maintaining overall health and well-being for several reasons:

1. Early detection and prevention

Preventive care includes routine health services such as annual physical exams, vaccinations, and screenings for conditions like cancer, high blood pressure, high cholesterol diabetes and other chronic diseases. These services help detect health issues early, often before symptoms appear, making them easier and less costly to treat.

2. Cost savings

By identifying and addressing potential health problems early, preventive care can reduce the need for more expensive treatments down the line. This can lead to significant savings on medical expenses over time.

3. Improved health outcomes

Regular preventive care helps manage and prevent chronic diseases, leading to better health outcomes. For example, screenings for high blood pressure and cholesterol can prevent heart disease, while regular cancer screenings can catch cancers at an early, more treatable stage.

4. Comprehensive coverage

Most health plans, including Priority Health, cover preventive services at no cost to you. This means you can access essential health services without worrying about copayments, coinsurance or deductibles, as long as you use a provider within your plan's network.

5. Personalized health management

Preventive care visits allow healthcare providers to tailor health advice and services to your specific needs based on your age, gender and health history. This personalized approach helps you make informed decisions about your health and lifestyle.

6. Enhanced quality of life

By preventing serious health issues and managing existing conditions, preventive care contributes to a higher quality of life. It helps you stay healthy, active and able to enjoy daily activities without the burden of untreated health problems.

What preventive services are covered?

Most health plans cover a set of preventive services at no cost, including immunizations, well-baby and well-child visits and screenings for various health conditions. For a comprehensive list of covered services, see Priority Health's Preventive Health Care Guidelines or go to Healthcare.gov.

Are there preventive services specific to women?

Yes, there are preventive services specifically for women, such as mammograms, cervical cancer screenings and prenatal care. For a detailed list of preventive care benefits for women, see Priority Health's Preventive Health Care Guidelines.

Does my plan cover preventive care for children?

Many plans cover preventive care for children, including immunizations and well-child visits. See Priority Health's Preventive Health Care Guidelines to learn more about preventive care benefits for children.

Are preventive services free?

Preventive services are typically covered at no cost to you when provided by a doctor or provider in your plan's network, but it's always a good idea to check with your insurance provider.

How often should I get preventive care?

The frequency of preventive care services can vary based on age, gender and health status. For example, annual physical exams and certain screenings are recommended yearly.

What happens if I need a service that isn't considered preventive?

Services not classified as preventive, such as diagnostic tests or treatments for existing conditions, may require you to pay out-of-pocket costs or meet your deductible.

What should I expect during a preventive care visit?

During a preventive care visit, you can expect assessments like height, weight and body mass index (BMI) measurements, heart rate checks and various screenings based on your age and health needs.

How can I prepare for a preventive care appointment?

Bring a list of medications you're taking, including all prescriptions, over-the-counter meds, vitamins and supplements with dosages.
Know your family health history, noting any chronic conditions or significant illnesses in close relatives.
Write down questions and concerns and come prepared with health-related questions or symptoms you want to discuss.
Bring personal health records, such as recent test results, immunization records and specialist reports.
Be ready to talk about your lifestyle information, including your diet, exercise, sleep, alcohol use and smoking habits.
Have your insurance information, including your insurance card and check coverage for preventive services.
Wear comfortable clothing that allows easy access for exams.
Arrive early to give yourself time to complete paperwork and relax before your appointment.

Can I see any doctor for preventive care?

You can see any doctor, but to avoid out-of-pocket costs, it’s best to choose a provider within your plan's network.

How do I know which preventive services I need?

Your health care provider can help determine which preventive services are appropriate for you based on your health history and risk factors.

Why Priority Health?

Priority Health offers a range of plans that cover essential preventive services at no cost to you, helping you maintain your health and well-being. More than 89%¹ of members stayed with MyPriority^® year over year. When you shop for health care with MyPriority, you get the most value for what matters most to you.

Our offerings include award-winning customer service², chronic condition management with low-cost benefits for some of the most common conditions, low prescription co-pays and on-demand mental health support. Choose MyPriority for comprehensive and affordable health care that meets your needs.