Under the Affordable Care Act, no co-pays for some preventive services
**Editor’s Note: Although Medicare regularly provides coverage for preventive services given high grades by the U.S. Preventive Services Task Force, it is not required to do so.**
Under the ACA, some preventive services are now required to be covered with no copay by private insurance companies. Special correspondent Dr. Emily Senay reports.
Some of these services include: screenings for HIV, cervical cancer and osteoporosis, as well as counseling for obesity and tobacco use. Some of these services include: screenings for HIV, cervical cancer and osteoporosis, as well as counseling for obesity and tobacco use.
The task force is composed of 16 volunteer and independent physicians and academics, who consider which screening tests are proven to work. The group operated with little notice for nearly three decades, using letter grades to recommend which preventive services doctors should provide and what insurance companies ought to cover.
But now because of the new health care law, health care insurance providers are required to cover the out-of-pocket expenses for screenings, medications and immunizations that are given high grades by the task force. Although Medicare regularly provides coverage for many of these services, it is not required to do so.
“A preventive service is something that is intended to keep something bad from happening,” said Dr. Virginia Moyer, chair of the task force.
“What we do as a task force is we carefully evaluate the science that tells us whether a preventive service is going to benefit people.”
The idea behind the new law is providing preventive services from the outset will save lives and health care dollars down the road. However, critics question whether the task force is able to handle its new role, as well as how this new requirement may impact health care costs in the long run.
Medical correspondent Dr. Emily Senay also speaks to a longtime smoker who decided to get her first preventive lung cancer screening test 18 years ago. The task force recently gave a high recommendation to low dose CT scans for lung cancer. If the task force finalizes the grade for this screening, private health insurers will be required by the Affordable Care Act to cover it with no copay.