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Expanded Preventive Services Still Vague On Details

09/30/11

  06:03:18 pm, by MedBen5   , 255 words,  
Categories: News, Health Plan Management

Expanded Preventive Services Still Vague On Details

The New York Times recently examined an imminent change to most health insurance plans: 100% coverage of an expanded list of preventive services.

Many insurers, including MedBen, already cover in full a variety of wellness services for adults, children and babies. These typically include checkups, routine immunizations and various cancer screenings, when performed by a doctor in the insurers’ network. But the Affordable Care Act will broaden the list of preventive services covered at 100% to include depression and obesity screenings, contraception for women, and lead screening for children at risk of exposure, to name just a few. (A complete list is available at www.healthcare.gov.)

As NYT notes, there’s still a fair amount of ambiguity about what qualifies as preventive care and what insurers must cover. The federal government is still defining the guidelines, leaving physicians to decide when and how often preventive care should be given – and insurers to decide whether the care should be covered in full.

The new services will be in place by August 2012, but not every policyholder will see changes to their benefits. Insurance plans in effect before March 23, 2010 are considered grandfathered if no major changes have been made to their design or cost-sharing structure. However, the number of plans that meet this critieria has decreased as more employers make benefit changes.

Of course, MedBen will notify its clients as to any major changes in their preventive benefits coverage. And clients with questions about what preventive services are covered under their plan may call MedBen Customer Service at (800) 686-8425.

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