10 new health insurance freebies

If you have health insurance and have been putting off a colonoscopy, mammogram or other test, you now have one less excuse.

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Health insurance reform requires that new group or individual health plans created or purchased since March 23, 2010, cover 100 percent of the costs of preventive care. That means you don't have to pay a deductible, coinsurance or copay for a variety of tests and treatments.
Keep in mind, though you still might have to pay a copay for an office visit if the preventive care is billed separately. Also, the law requires health plans to provide this fully-covered care only through in-network clinicians.
Here are 10 new health insurance "freebies." All of the following testing recommendations come from guidelines established by the U.S. Preventative Services Task Force.

1. Diabetes, blood pressure and cholesterol tests

High blood pressure and high cholesterol levels increase the risk for heart disease. Health insurance reform now covers tests for these conditions.
Blood pressure screening is recommended for all adults. Screening for Type 2 diabetes is recommended for adults with high blood pressure.
Cholesterol screening is recommended for:

• Men 20 to 34and women 20 and older who are at risk for heart disease
• All men 35 and older

2. Breast, cervical and colon cancer screenings

The American Cancer Society estimates health reform preventive provisions could double cancer screening rates among the newly insured, thereby saving tens of thousands of lives a year.
"Evidence shows that we could prevent as many as two-thirds of cancer deaths in this country with a proper focus on prevention," says John Seffrin, CEO of the American Cancer Society Cancer Action Network.
Under health insurance reform, fully covered screenings include:

• Mammograms to screen for breast cancer every one to two years for women over 40
• Regular pap smears to screen for cervical cancer for sexually active women
• Colonoscopies to screen for colon cancer for adults over 50

3. Health education counseling

Want to quit smoking but don't know how? Need advice on how to cut down on alcohol? Health counseling is fully covered to help you achieve these goals and others, such as how to improve eating habits and treat depression.
Counseling is eligible for coverage if it comes from your primary care doctor or a specialist or program referred by your doctor. Talk to your physician and check with your insurance plan to see what is covered.
"For decades our health care system has waited to treat people until they get sick, but the Affordable Care Act shifts the emphasis to disease prevention and management as well as improved wellness and quality of life," Seffrin says.

4. Routine vaccines

You don't have to pay anything out of pocket to get your kids immunized, except perhaps a copay for an office visit if the immunizations are billed separately. Fully covered vaccines include hepatitis A and B; tetanus, diphtheria and pertussis; measles, mumps and rubella; varicella (chickenpox); and other standard recommended shots. Routine vaccines for adults are also covered.

5. Flu shots

Each year, somewhere between 5 percent and 20 percent of the U.S. population gets the seasonal flu, according to the Centers for Disease Control. Most people recover, but flu can be lethal.
New plans now must fully cover the cost of flu shots. The CDC recommended vaccination for everyone 6 months and older during the most recent flu season.

6. Counseling and screening for healthy pregnancies

The U.S. infant mortality rate is about seven deaths for every 1,000 live births, disturbingly high for an industrialized nation, according to the U.S. Department of Health and Human Services. About 8.2 percent of babies have a low birth weight, an increase of 17 percent since 1990.
Under health insurance reform, fully covered services during pregnancy include:

• Screening for conditions that can hurt women or their babies, including iron deficiency, hepatitis B, a pregnancy-related immune condition called Rh incompatibility and a bacterial infection called bacteriuria
• Counseling from a doctor to help pregnant women quit smoking and avoid alcohol
• Breast-feeding counseling and education to help nursing mothers.

7. Well-baby and well-child visits

Children in the United States receive recommended health care less than half of the time, according to a 2007 study from the RAND Corporation, Seattle Children's Hospital Research Institute and the University of Washington School of Medicine.
Under health insurance reform, fully covered services include:

• Screenings and health counseling to prevent and treat obesity among children, depression among adolescents, and dental cavities and anemia.
• Routine vaccinations and boosters
• Well-child visits to the doctor from birth to age 21

8. HIV and sexually transmitted disease screening

A new system to track HIV infection estimates that 56,300 U.S. residents were newly infected with the disease in 2006, the latest year such statistics are available, according to the CDC.
Screening for HIV and sexually transmitted diseases and behavioral counseling to prevent infection are now fully covered:

9. Osteoporosis screening

Osteoporosis occurs when bones become more porous and lose mass, making them susceptible to fractures and breaks with even simple activities, such as picking up a child, bumping into furniture or sneezing.
Health reform calls for routine screening for osteoporosis, which is recommended for all women 65 and older and for women 60 to 65 who are at increased risk for the condition.

10. Obesity screening and weight loss counseling

Two-thirds of Americans qualify as overweight or obese, according to the National Institutes of Health. Even more startling, 17 percent of women and 11 percent of men are severely obese.
Obesity increases risk of Type 2 diabetes, heart disease and a host of other health problems.
Screening for obesity and intensive health counseling and education now is fully covered to promote sustained weight loss for obese adults and obese children 6 and older. Your primary-care doctor may offer the health counseling or refer you to a specialist, such as a dietitian. Always check with your health plan before you schedule services to make sure they qualify for free coverage.

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All You Need to Know About Health Insurance

With medical expenses soaring higher every year, health insurance is an expensive necessity. Knowing more about health insurance can help you get the coverage you need while keeping your expenses down.

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What types of health insurance are available?

Health insurance plans generally fall into one of two categories: indemnity plans (also known as reimbursement plans) and managed care plans such as health maintenance organizations (HMOs), preferred provider organizations (PPOs), and point of service (POS) plans. (Learn more about HMO, PPO, and POS plans.)

• An indemnity plan allows you to choose your own doctors and pays for your medical expenses - totally, in part, or up to a specified amount per day for a specified number of days.
• Managed care plans generally provide broader coverage, but they all involve an arrangement between the insurer and a selected network of health-care providers (doctors, hospitals, etc.). This arrangement provides a strong incentive for you to stay in-network, usually by covering less for services received outside the network.

No matter which type of health insurance you buy, you'll need to make sure it offers the right kinds of coverage.

What should be covered?

A good health insurance policy contains several types of coverage.

• Hospital expense coverage pays your room, board, and incidental services costs if you're hospitalized
• Surgical expense coverage covers surgeons' fees and related costs associated with surgery
• Physicians' expense coverage pays for visits to a doctor's office or for a doctor's hospital visits
• Lab coverage pays for laboratory services like X-Rays and other diagnostic lab tests

What might be covered?

When comparing health insurance plans, check to see if they provide additional benefits that you may need, including:

• Prescription drugs
• Preventive care
• Mental health benefits
• Maternity care
• Vision care
• Dental care
• Chiropractic coverage

What will it cost?

In addition to the monthly premium expense, you may have other out-of-pocket costs. These costs can really add up, especially if you have children or other family members who visit the doctor frequently. Check to see if the health insurance plan you're considering requires you to pay any or all of the following:

• Co-payment: The flat fee you'll have to pay each time you visit a health insurance provider (can vary by provider type).
• Deductible: The amount you'll have to pay toward your medical expenses (usually annually) before the insurance company begins to pay claims (generally required by indemnity plans).
• Coinsurance: The percentage of your medical costs you'll have to pay after you reach any deductibles that apply.

Where can I get health insurance?

You may get health insurance through a group plan at work or through another group affiliation (a school, a club, etc.) or by purchasing an individual plan on your own. By purchasing an individual plan, you may be able to customize the health plan.
A good way to compare rates, plans, and options for your individual needs is to shop online. Comparing online health insurance quotes helps to ensure you get your best rate.

How do I decide which plan is best?

The best health insurance plan for you is the one that gives you the greatest flexibility and the most benefits for the lowest cost. Unfortunately, there's no such thing as a standard health insurance plan. As you would when making any major purchase, you'll need to shop around and get several quotes before choosing a plan. Here are a few points to consider:

• What co-pays, deductibles, and coinsurance requirements apply?
• How much freedom do you have to choose your own health-care providers?
• Does the plan cover the health services that you need?
• Does the plan cover the health-care providers you're currently using?
• Does the plan offer family, as well as individual, coverage?
• Does the plan cover pre-existing conditions? If so, is there a waiting period?
• Does the insurance company have a good reputation in the industry and a positive rating from a major ratings organization and your state's department of insurance?

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No dental insurance? Here are 3 options

Can't get dental insurance coverage through your employer? If not, you may be tempted to skip dental cleanings and other treatments. But good basic care lowers your risk of suffering a major, expensive problem in the future.

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There are three ways to approach dental care if you don't have employer-based coverage – purchase your own private insurance, opt instead for a discount plan or simply pay for services out of pocket as you need them.
Each approach has its own risks and rewards.

Private dental insurance plans

In some cases, you may be able to purchase group dental insurance and private insurance plans on your own even if you can't get coverage through your employer.
Group dental insurance typically costs less than individual insurance. In some states, organizations such as AARP and businesses like Costco offer dental plans at group rates to members, says Elizabeth Risberg, a spokesperson for Delta Dental.
If you don't qualify for group coverage, consider buying individual dental insurance. Individual plans advertise costs of around $200 to $300 annually, which is higher than many group plans charge, says Amy Bach, executive director of United Policyholders, an insurance consumer advocacy organization in San Francisco.
Risberg says there are ways to lower those costs. Plans with higher deductibles often offer lower premiums. Other plans offer greater affordability in exchange for your agreeing to choose services from a more restricted network of dentists.
Dental insurance plans may have restrictions on certain services, such as orthodontic work, Bach says. Many dental plans also have a maximum benefit of around $1,000 to $2,000 per year.
Plans also may restrict coverage of pre-existing conditions or refuse to cover preventative care options such as dental sealants or fluoride treatments. But many other preventative services are likely to be covered through insurance.
"With dental insurance, procedures such as cleanings and x-rays are encouraged, so they're usually covered for no or low cost," Risberg says.  "And a lot of the time, the deductible doesn't apply for those preventive services."
Ask providers what they will and will not cover before purchasing a plan.

Discount dental plans

Discount dental plans are an alternative to dental insurance. These plans require participants to pay a fee to access a network of dentists who offer services at reduced prices.
The fee, which typically is paid once a year, is likely to be less than the cost of private dental insurance, says Bach. In fact, many plans advertise annual costs of about $100 a year for individuals, less than half the annual premium of many insurance plans, she says.
With discount dental plans, you typically pay less than full price for preventive services, such as cleanings and x-rays, as well as other procedures, including root canals and orthodontia, says Bach.
Unlike dental insurance, you'll probably have to pay at least some money out of pocket for cleanings and other preventative services.  On the other hand, discount plans may offer reduced rates for services that aren't covered at all under standard insurance, such as cosmetic dentistry. So if you're planning to have aesthetic work done in the near future, a discount plan could be cost effective, Bach says.
However, if you're not familiar with your dentist under a discount plan, remain on guard.
"You may think you're getting a deal with a discount plan, but if the participating dentist prescribes a bunch of services you don't actually need, you could end up paying more," Bach says.

Pay-as-you-go dental care

You may be tempted to skip insurance coverage or a discount plan and simply pay for services as they are needed. After all, as Bach points out, skipping dental coverage is unlikely to put you at the same degree of financial risk as skipping health insurance.
However, Risberg reminds you that a dental crisis could still leave you facing big, unexpected bills if you don't have insurance.
"You don't always know what type of dental situation you're going to have," she says.  "You might have an emergency, or crack a tooth and need a crown.  That's not ever something that you can plan for."
Before going coverage-free, Bach suggests adding up the costs of routine services you and your family would likely need in a year, such as cleanings and x-rays, and comparing them to the out-of-pocket costs of dental services in your area.
"If you're a single adult and you're in good dental health, it may be unlikely that private insurance is worth it, after you do the math," says Bach.
If you forgo coverage and a problem arises, use your lack of insurance to try to negotiate lower fees with your dentist, she says.
"Find a dentist whom you trust, tell him or her that you don't have insurance, and then see if you can work out an agreement for a lower rate on services," she says.

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