avoiding costly surprises

avoiding costly surprises

Experts offer the following tips for avoiding surprise medical bills for preventive care:

Call your insurance plan — the 800-number on the back of your insurance card — to find out whether the plan must comply with the Affordable Care Act. If your plan is “grandfathered,” it’s exempt from the law’s requirement to pay for preventive care.

When scheduling an appointment or talking with your doctor, clarify that you’re coming in for a covered preventive service and you don’t expect to be charged. The doctor must be in your health plan’s network.

If you’re hit with an unexpected bill, call the doctor’s office and ask how the bill was submitted. Was it submitted as a preventive-care service?

Complain to your state’s insurance department if you think you’ve been billed in error.

The following is a partial list of services that should be covered without co-pays or other cost-sharing by the patient:

Alcohol-misuse screening and counseling

Aspirin use for men and women of certain ages

Blood-pressure screening for all adults

Cholesterol screening for adults of certain ages or at higher risk

Colorectal-cancer screening for adults, starting at age 50

Depression screening for adults

Type 2 diabetes screening for adults with high blood pressure

Diet counseling for adults at higher risk for chronic disease

HIV screening for all adults at higher risk

Flu shots and other recommended vaccines for adults and children

Obesity screening and counseling for adults and children

Tobacco-use screening for all adults and cessation interventions for tobacco users

Breast-cancer mammography screenings every 1 to 2 years for women over 40

Cervical-cancer screening for sexually active women

Folic-acid supplements for women who may become pregnant

Osteoporosis screening for women over age 60 depending on risk factors

Autism screening for children at 18 and 24 months

Depression screening for adolescents

Fluoride supplements for children without fluoride in their water source

Hearing screening for all newborns

Sources: U.S. Department of Health and Human Services; Georgetown University Health Policy Institute