10 Preventative Services That Keep You Healthy and Covered by Your Marketplace Plan

A visit to the doctor can be very enlightening and informative, but what if your doctor can’t tell you exactly what’s wrong? In some cases, that’s because there’s nothing wrong with you—at least, not yet. Rather than waiting for something bad to happen, it’s always best to be proactive about your health and have regular checkups and preventive services. To keep you healthy and covered by your Marketplace plan, these are the 10 most important preventative services that you should see your doctor about at least once a year.

The Basics

Health insurance plans in a Health Insurance Marketplace (also called health exchanges) must offer these ten preventive services without charging you anything out-of-pocket. If your plan doesn’t cover one of these services, it must provide you with a free rider – an insurance policy that covers preventive care at 100% after deductible. These free riders are only available to people who have both Medicare and Medicaid.

Anemia Screening

Anemia is a condition in which you have too few red blood cells, or low levels of hemoglobin (the oxygen-carrying part of red blood cells). If left untreated, anemia can cause weakness, fatigue, shortness of breath and other complications. So if you have any concerns about your iron levels or feel fatigued or unusually weak for no apparent reason, be sure to get tested. Screenings are available from your doctor or at some clinics at no cost under your plan.

Pressure Screenings

Heart disease remains one of America’s biggest killers, but high blood pressure is its primary risk factor. Learn about how high blood pressure affects you, what to look for when talking to your doctor about managing it, and which lifestyle changes you can make now that can help keep your heart in top shape.

Breast Cancer Tests

If you are concerned about breast cancer, start your preventive health care efforts with a mammogram. The Affordable Care Act makes it possible for women to get screened early, when treatment options are more effective. (To be eligible for preventive services, you must have minimum essential coverage through an individual plan or job-based insurance.) Under President Obama’s Affordable Care Act, most plans will cover many of these services without charging a co-pay or deductible – check your policy to make sure your benefits are up to date.

Colorectal Cancer Tests

The colorectal cancer screening test, called a fecal occult blood test (FOBT), is used to find hidden (occult) blood in stool samples. A positive FOBT result may mean you need a sigmoidoscopy or colonoscopy. These tests can find changes in your colon or rectum that may be too small to see or feel during a regular exam.

Diabetes Screenings

Some marketplace plans will now cover screenings for diabetes, a disease that increases your risk of heart attack, stroke, kidney failure, blindness and limb amputation. Diabetes can’t be cured, but it can be controlled with lifestyle changes like diet and exercise. If you think you may have diabetes, get tested—the sooner you catch it, the easier it is to manage.

Glaucoma Screenings

Getting your eyes checked regularly for glaucoma, an eye disease that can cause blindness if left untreated, is a smart idea for anyone concerned about preventing common eye health issues. The Affordable Care Act requires plans to cover glaucoma screenings for people over age 40. For everyone else, it’s important to get regular exams. Though there are no symptoms of glaucoma until you’ve already lost some vision, it can be detected in its early stages with regular checkups.

Lung Cancer Tests

Lung cancer is one of the most common forms of cancer in America, but it’s also one of the easiest to treat when caught early. With lung cancer tests, you can help keep yourself healthy by catching a disease before it becomes too late. And whether you’re looking for low-cost or free lung cancer screening options in your area, there are plenty of affordable ways to stay on top of your health.

Flu Shots

Getting a flu shot every year is one of the easiest ways to stay healthy. Flu shots are free to all enrollees with marketplace plans, so don’t forget yours next year! Remember that anyone can get sick from a cold or flu, including those with good health insurance, but getting a flu shot on time could help you feel better faster if you do get sick. Flu shots are recommended for everyone over 6 months old.

Mammograms, Pap Smears, Pelvic Exams and Prostate Tests (Mammograms & Pap smears)

A mammogram is a low-dose X-ray used to detect breast cancer, while a Pap smear is used to detect cervical cancer. In both cases, these tests can help find disease early on. Over 200,000 women in America die each year from breast or cervical cancer—which means there’s every reason to take advantage of preventive services available through your plan. If you have one of these plans, talk with your doctor about scheduling a mammogram or Pap smear.


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