Out-of-Pocket Estimates for Preventive Health Care

Preventive care can help you stay healthier throughout your life. For many people, certain preventive health care is now free, with no copays or deductibles. Learn about the preventive care that you and your loved ones need and ask your MUSC Health Care team provider what health care you need to stay healthy.

What is Preventive Care?

Preventive care includes health services like screenings, check-ups, and patient counseling that are used to prevent illnesses, disease, and other health problems, or to detect illness at an early stage when treatment is likely to work best. Getting recommended preventive services and making healthy lifestyle choices are key steps to good health and well-being.

Most health plans must cover a set of preventive services, like shots and screening tests, at no cost to you.

These services are free only when delivered by a doctor or other provider in your plan’s network.

Preventive Care Benefits for Adults

All marketplace health plans and many other plans must cover the following list of preventive services without charging you a copayment or coinsurance. This is true even if you haven’t met your yearly deductible.

• Abdominal aortic aneurysm one-time screening for men of specified ages who have ever smoked
• Alcohol misuse screening and counseling
• Aspirin use to prevent cardiovascular disease for men and women of certain ages
• Blood pressure screening
• Cholesterol screening for adults of certain ages or at higher risk
• Colorectal cancer screening for adults over 50
• Depression screening
• Diabetes (Type 2) screening for adults with high blood pressure
• Diet counseling for adults at higher risk for chronic disease
• Hepatitis B screening for people at high risk, including people from countries with 2 percent or more Hepatitis B prevalence, and U.S.-born people not vaccinated as infants and with at least one parent born in a region with 8 percent or more Hepatitis B prevalence.
• Hepatitis C screening for adults at increased risk, and one time for everyone born 1945 to 1965
• HIV screening for everyone ages 15 to 65, and other ages at increased risk
• Immunization vaccines for adults — doses, recommended ages, and recommended populations vary:
  • Diphtheria
  • Meningococcal
  • Hepatitis A
  • Mumps
  • Hepatitis B
  • Pertussis
  • Herpes Zoster
  • Pneumococcal
  • Human Papillomavirus (HPV)
  • Rubella
  • Influenza (flu shot)
  • Tetanus
  • Measles
  • Varicella (Chickenpox)
• Lung cancer screening for adults 55 to 80 at high risk for lung cancer because they’re heavy smokers or have quit in the past 15 years
• Obesity screening and counseling
• Sexually transmitted infection (STI) prevention counseling for adults at higher risk
• Syphilis screening for adults at higher risk
• Tobacco use screening for all adults and cessation interventions for users

Other covered preventive services for women

• Breast cancer genetic test counseling (BRCA) for women at higher risk
• Mammography screenings every one to two years for women over 40
• Breast cancer chemoprevention counseling for women at higher risk
• Cervical cancer screening for sexually active women
• Chlamydia screening for younger women and other women at higher risk
• Domestic/interpersonal violence screening and counseling for all women
• Gonorrhea screening for all women at higher risk
• HIV screening and counseling for sexually active women
• Human Papillomavirus (HPV) DNA test every three years for women with normal cytology results who are 30 or older
• Osteoporosis screening for women over age 60 depending on risk factors
• Rh incompatibility screening follow-up testing for women at higher risk
• Sexually transmitted infections counseling for sexually active women
• Syphilis screening for women at increased risk
• Tobacco use screening and interventions
• Well-woman visits to get recommended services for women under 65

Many of the preventive services available at no charge are included in this Choices Magazine (PDF). Ask your health care team about any services you have questions. It’s your health. We look forward to helping you achieve the best health and peace of mind.