No-cost insurance for certain medical procedures has become an emerging issue among patient advocates and medical professionals. Services such as biopsies that diagnose health problems should be free, as well as lab tests, say the most vocal advocates. Here’s a look at who pays for preventive care and diagnostic tests.
Free Preventive Healthcare
The Affordable Healthcare Act (ACA) provided Americans with easier access to preventive healthcare services. One of the law’s requirements for most private health plans is to cover the entire range of preventive services without charging copays or deductibles. Since 2010, the ACA has required health providers to cover preventive services backed by scientific evidence at no extra cost to patients.
Surprise Medical Diagnostic Bills
Despite the clarity of the ACA, many patients have been charged out-of-pocket costs for certain diagnostic procedures. For example, a 39-year-old Houston patient named Cynthia Johnson was told to pay $200 out-of-pocket for a diagnostic mammogram to find out if she had breast cancer. Although initially hesitant, she decided to put it on her credit card.
In 2018 the mammogram revealed Cynthia had a lump in her breast. She then went through cancer treatment steps, including chemotherapy, and eventually beat cancer. The fact that she almost passed on the mammogram is an example of how out-of-pocket healthcare costs can create barriers between patients and their healthcare needs.
Surprise medical costs can shock patients into making poor health decisions. Nonetheless, in a tightening economy, it’s extremely difficult for many Americans to come up with $200, especially if they cannot afford to put money in savings. The rising cost of living constraints makes it necessary for patients to cut costs as much as possible.
One of the ways in which patients encounter surprise costs is when a screening yields unusual results, which calls for more diagnostic testing. These tests can cost thousands of dollars, which can elevate anyone’s stress levels.
Relief for Patients with Follow-up Tests
Many times follow-up tests have led to out-of-pocket charges, such as for a colonoscopy, which is a procedure to detect colon cancer. Some patients have paid as much as $7,000 from their own pocket to cover this procedure. A 2010 study of health insurance claims found that the average out-of-pocket expenses for patients diagnosed at the first few stages of cancer exceeded $82,000.
However, a new federal rule that echoes what nine states already require now makes it possible for patients who are covered with healthcare insurance to avoid high costs for screenings. The new rule prevents healthcare insurance providers from charging patients for cancer screenings and encourages patients to seek the necessary preventive care. Since follow-up tests are considered imperative for diagnosing an illness, they must be free, according to the new rule, reconfirming the ACA’s intent.
Conclusion
Contact us at Donald Weiss Insurance Services to learn more about how we can help you find the right healthcare insurance plan for your personal needs. We are an independent insurance agency that works with various notable healthcare insurance providers.