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No out-of-pocket cost on some preventive care

Ricardo Alonso-Zaldivar | Hagadone News Network | UPDATED 14 years, 4 months AGO
by Ricardo Alonso-Zaldivar
| July 15, 2010 9:00 PM

WASHINGTON - From counseling for kids who struggle with their weight, to cancer screenings for their parents, preventive health care will soon be available at no out-of-pocket cost under consumer rules the Obama administration unveiled Wednesday.

That means no copays, deductibles or coinsurance for people whose health insurance plans are covered by the new requirements.

The Obama administration estimates that 41 million Americans will benefit initially, with the number projected to rise to 88 million by 2013. Many large company plans, which usually offer solid preventive benefits, will be exempt from the requirements for the time being.

Better preventive coverage is one of the goals of President Barack Obama's health care overhaul law, part of a shift to try to catch problems early, before high cholesterol can lead to heart disease.

"Services like these will go a long way in preventing chronic illnesses that consume over 75 percent of the health care spending in this country," said first lady Michelle Obama, announcing the new benefits at a Washington hospital.

Better preventive care may be an investment, but it still carries an upfront cost. Premiums will go up by 1.5 percent on average, as spending for the services is spread broadly across an entire pool of insured people.

For individuals who are diligent about their checkups, that can mean considerable out-of-pocket savings. For example, a 58-year-old woman at risk of heart disease could save at least $300 out of her own budget on recommended tests, ranging from diabetes and cholesterol screening, to a mammogram and a flu shot.

Research has shown that people tend to skip recommended preventive care if cost is an issue, and even a modest copayment can make a difference. Cost-free prevention was one idea that received widespread support during the contentious health care debate last year in Congress.

The prevention requirements take effect for health plans renewing on or after Sept. 23, which means most beneficiaries will see them starting Jan. 1. Coincidentally, that's also when Medicare recipients get access to most preventive services at no out-of-pocket cost - another change under the health care law.

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