Get the most out of your health insurance

By The Health News Team | August 15, 2023
Senior man talking to his doctor

You did your research and chose the right health insurance plan for you and your family. Now, you won’t have to worry about the financial risk if someone gets sick or injured and needs care. But did you know that your benefits do much more than just help you pay for health care? Most health insurance plans cover a variety of free preventive care benefits that can help keep you and your family healthy.

“Many preventive services, like screenings and tests, are available at no additional out-of-pocket cost,” explains Don Truong, director of sales at Sharp Health Plan. “Taking advantage of these free services can help reduce your health care costs over time by keeping you and your family healthy.”

There are nine things most health insurance plans cover at no additional charge when received within your network. However, some of these preventive care services may require a referral from your primary care doctor.

1

Preventive care visits.

Preventive care visits are intended to help prevent illnesses by evaluating your current state of health and discussing how to maintain a healthy lifestyle. However, if you schedule a preventive care visit and ask your doctor about a specific health concern or condition during that visit, your doctor may bill you for an office visit. You should plan to schedule your annual preventive care visit at least two months in advance to accommodate a potentially busy doctor’s office.

2

Preventive vaccines.

Protect yourself from common illnesses by staying up to date on your vaccines. Most health insurance plans cover vaccines for the flu, chickenpox, COVID-19, hepatitis A and B, MMR, HPV, DPT, polio and more. Your primary care doctor will recommend the necessary vaccines for your age and risks.

3

Prenatal checkups.

Expectant mothers have access to many different pregnancy benefits, including free prenatal checkups, sexually transmitted infection (STI) screenings, and anemia and gestational diabetes screenings.

4

Well-baby and well-child exams.

Your child has coverage for all wellness exams, which will address their immunization schedule and measure their growth, nourishment and development. Children typically receive wellness exams on the following schedule:

  • Directly after birth

  • 1 week old

  • 1 month old

  • 2 months old

  • 4 months old

  • Every 3 months from age 6 months to 18 months old

  • 2 years old

  • 2 1/2 years old

  • Once per year from age 3 years through 18 years old

5

Mental health and substance abuse screening.

Your mental health is just as important as your physical health. Most health insurance plans cover mental health and substance abuse preventive care, allowing you to access different types of care, such as depression and alcohol misuse screenings, as well as counseling, including tobacco use and domestic abuse counseling. Talk to your primary care doctor about these services.

6

Annual well-woman exam.

Every year, women can visit their OBGYN or primary care doctor for a well-woman exam, which focuses on your reproductive health and the health of your vagina, cervix, uterus and breasts. These exams usually include a pap smear, pelvic exam and breast exam.

7

Reproductive health benefits.

Most health plans offer reproductive health benefits, such as free contraception, counseling and STI screenings for HIV, syphilis, gonorrhea and chlamydia.

8

Cancer prevention benefits.

The best way to treat cancer is with early detection. Your primary care doctor might recommend one of several preventive services, including screenings for breast cancer, cervical cancer, colon cancer and lung cancer.

9

Heart health benefits.

Keep your heart healthy with blood pressure and cholesterol screenings, as well as aspirin coverage. Check with your health plan to see what's covered under your benefit plan.

For the best member experience, please check your Member Handbook (also called your Evidence of Coverage or EOC) to verify what is covered under your specific plan. If you’re enrolled in benefits with Sharp Health Plan, access your EOC by logging in to your Sharp Connect account.

Sharp makes it easy to get the care you need. Learn more at sharp.com/choosesharp.


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