What is preventive care?
Preventive care is important because it helps keep you healthy. It can stop health problems before they start or find them early when they are easier to treat. Taking care of your health now can help you avoid bigger problems later.
Preventative care includes things like:
- Annual wellness visits (also known as physical exams or check-ups)
- Vaccines (also known as immunizations)
- Screening tests for cancer or other health problems
Preventive care goes beyond these. It also includes learning about:
- Eating healthy foods
- Getting regular physical activity
- Managing stress
- Having good sleep habits
- Limiting how much alcohol we drink
- Stopping tobacco use and smoking
Understanding these can help us live healthier lives!
Who needs preventive care?
Everyone needs regular preventive care! Your provider can tell you about the screenings, tests and vaccines you should get.
Are preventive services covered by CCHP?
CCHP covers many preventive services at no out of pocket cost when you use an in-network provider. Check out our “Find a Doctor” page to find an in-network provider!
You can see a list of preventive services covered by CCHP in the Preventive Services Reference Guide.
- CCHP fully covers the preventive services recommended by the United States Preventive Service Task Force (USPSTF) as grades “A” or “B”. To learn more about the USPSTF Recommendations and which services have been graded “A” or “B”, visit the USPSTF website.
- CCHP follows the rules of the Affordable Care Act (ACA) for full coverage of certain preventive services. To learn about the preventive services included in the ACA rules, visit the Preventive Health Services page on HealthCare.gov.
- The ACA identifies specific preventive services that must be fully covered by your health insurance. However, your provider might suggest other services to help prevent illness that are not covered by the ACA rules. For these services, you may need to pay some costs.
- Common preventive services covered under the ACA rules include:
- Blood pressure screening
- Obesity screening and counseling
- Depression screening
- Immunizations and vaccines
- Colorectal cancer screening
- Common services to prevent disease and illness that are NOT covered under the ACA rules include:
- Vitamin D blood test
- Thyroid stimulating hormone (TSH) blood test
- Comprehensive Metabolic Panel (CMP) blood test
- Prostate-Specific Antigen (PSA) blood test
- Complete Blood Count (CBC) blood test
- Some tests, like cholesterol screening, may only be preventive if your provider bills the test as such on the claim. Please talk to your provider for your specific preventive health recommendations.
- Click here to see an example of how the USPSTF recommendations and ACA rules are applied by CCHP’s plan benefits for common preventive services.
Check your Schedule of Benefits for details about what you may need to pay for other services covered by your plan as non-preventive.
For more information about your plan benefits and additional incentives that CCHP offers, log in to your CCHP Wellness Portal.
What is the difference?
Wellness visit vs. other office visit
Even if you schedule a visit for a wellness visit, if you and your provider talk about symptoms or you already have, your provider might bill for BOTH a wellness visit and an office visit. You may have some cost responsibility for the office visit portion. Click here to see an example .
Screening tests vs. diagnostic tests
Preventive services such as screening tests happen before a condition or problem develops. Once you have developed symptoms or have been diagnosed with a condition, the services to manage and treat that condition are considered diagnostic.
The same test may be considered a screening test for one person, but a diagnostic test for another person. Click here to see some examples.
CCHP relies on your provider to tell us whether a particular test was screening or diagnostic. When your provider recommends a test, ask if they are recommending it as preventive or diagnostic.
Have more questions? Contact us!
Call our customer service line at (844) 201-4672.
- Available Monday - Friday 8 a.m.-6 p.m., Saturday 8 a.m.-2 p.m.
Fill out our contact form here: chorushealthplans.org/our-plans/contact-us.