Eating your vegetables and getting daily exercise are a great start to improving your health. But a healthy lifestyle does not stop there. Preventive care is one of the most important factors to living a healthy life and it is largely underutilized.
According to the Office of Disease Prevention and Health Promotion, preventive services have been steadily declining since the pandemic. And pre-pandemic rates of preventive care were not very high to begin with. This directly impacts our health and wellbeing because preventive care, when combined with healthy eating, exercise, vaccines, and early detection, is the key to a long and healthy life.
What Is Preventive Care?
Preventive care involves the early detection of medical problems, illnesses, and diseases, which helps your doctor provide proactive care and treatment. This type of care can include annual check-ups, immunizations and flu shots, and certain tests and screenings. Most preventive care is at no cost to you as part of your health coverage. Be sure to check your particular Coupe Health plan to see what is covered when it comes to preventive care services.
Early Detection of Potential Health Risks
It may feel like a hassle to visit your provider regularly, especially if you feel fine. But preventive care can help your doctor detect any potential health risks and start treatment earlier. Below are some examples of conditions that preventive care can help detect early.
- Diabetes: An increase of your sugar levels, which leads to other health complications. There are two types of diabetes, Type 1 and Type 2, and they may not have any visible signs. However, early detection and management can reduce the risk of further complications.
- Cardiovascular problems: Disorders related to your blood vessels and heart. These diseases can be fatal if left unchecked, which is why it is so important to see your provider on a regular basis.
- Problems with vision or hearing: Such disorders require immediate detection. If left undetected, they could worsen and become harder to treat. A preventive health check-up can ensure a timely diagnosis.
- Anemia: This problem occurs when you have a deficiency of iron in your body, making it harder to produce hemoglobin. As a result, your body does not get enough oxygen from your blood. Early detection and treatment can help get you back on track.
- Cancer: Cancer is caused by the unusual growth of cells in the human body. It can turn severe and fatal if not treated on time. However, detecting it at an early stage with a preventive health check-up provides more time for treatment.
How Often Do You Need Preventive Health Services?
These are examples of preventive health services and general preventive care guidelines. Always talk with your doctor about your specific healthcare needs.
- Annual check-up (1 per year): This is when your Primary Care Provider (PCP) checks all areas of your health, physical as well as emotional. This can help detect any health concerns before they become major medical problems.
- Flu shot (1 per year): This is typically 100% covered under most health plans and helps protect you from certain strains of the flu virus.
- Mammogram (1 per year, typically after the age of 40): Routine X-rays of breast tissue to check for any signs of cancer or other abnormalities.
- Colonoscopy (1 every 10 years, typically after the age of 45): Screening for colon cancer.
- Vaccinations (usually administered during childhood, includes boosters as needed): Vaccinations like measles, mumps, rubella, polio, and others are generally covered.
Examples of Vaccines and Preventive Exams
Below are examples of commonly recommended preventive care as well as a recommended timeframe for receiving certain care. This is not a complete list of all vaccines and preventive exams. Always talk with your doctor for more information on your specific healthcare needs.
Vaccines
- Flu: Yearly from age 18.
- TDaP: During every pregnancy. Every 10 years for all adults.
- Shingles: 1 to 2 shots starting as early as 50.
- Pneumonia: Age 50+, or younger if at risk.
Male Exams
- Testicular Exam: Yearly from age 18. Regular self-examinations are also recommended.
- Abdominal Ultrasound: Smokers aged 65 to 75.
Female Exams
- Pap Smear: Every 3 years, from age 21+.
- Mammogram: Every 1 to 2 years, as early as age 40.
- Bone Density Scan: Regularly from age 65.
Adult Exams
- Blood Pressure Test: Yearly from age 18.
- STD Screening: Yearly depending on sexual activity.
- Blood Sugar Test: Regularly from age 45.
- Colonoscopy: Every 10 years, from age 45.
- Cholesterol Test: Regularly from age 45+.
Preventive vs. Diagnostic
Depending on the nature of your exam, you may or may not have a copay.
Preventive: Most health plans offer some preventive health services at no additional cost when you see an in-network provider. If you are a Coupe member, you will not have to pay out-of-pocket for a preventive care appointment when you visit a doctor in your network. To see which providers are in-network, Coupe members can search for care in the member portal and app.
Diagnostic: Diagnostic exams relate to services in which your provider is looking for something specific, often based on the results of a preventive test or screening.
Note: These services are generally not preventive if you get them as part of a visit to diagnose, monitor, or treat an illness or injury. Copays may apply. Coupe members can call a Health Valet if they are unsure.
- Cholesterol Screening — Preventive: Done as part of an annual preventive care visit. The test is done based on your age or family history. You have not been diagnosed with high cholesterol. Diagnostic: You have high cholesterol, and your doctor is checking your numbers or is checking to see that the statin you are on is helping.
- Mammogram — Preventive: You have a visit for a routine mammogram or screening. Diagnostic: Your doctor orders a mammogram to learn more about a lump that was found.
- Colonoscopy — Preventive: You have no symptoms and go in for a routine colonoscopy. Diagnostic: You are having symptoms and your doctor orders a colonoscopy.
- Blood Test — Preventive: You have high blood pressure, a risk factor for diabetes, so your doctor does a routine diabetes blood check. The blood test is used to see if you need any further tests. Diagnostic: Your doctor orders a blood test because you have symptoms that may be caused by diabetes. The blood test is used to make the correct diagnosis as symptoms may mean different things.
What to Do When Scheduling a Preventive Care Appointment
When scheduling your appointment, whether you do it online or by phone, make sure to identify your visit as a preventive care service to the scheduler to avoid potential confusion.
Confirm with your doctor before you leave the office that they have listed the service as preventive.
Remind your doctor to indicate that any referrals or lab tests, such as blood work, mammogram, colonoscopy, and similar services through an external or additional provider, are for preventive services. This will help ensure these additional services are not billed as diagnostic visits. If you are a Coupe member and believe you have been billed incorrectly, please contact a Health Valet for assistance by calling the number on the back of your member ID card.
Get Ready for Your Checkup
Be prepared for your next checkup with these essentials and helpful pointers.
- Your member ID card: Before heading to your appointment, be sure you have your member ID card as you will need it to check in. Coupe members can save a digital version of their member ID card to their mobile device, so they are always prepared.
- A list of all the medications you take: Include all over-the-counter products, prescriptions, vitamins, and supplements you currently use. Some medicines may interact with each other. Always create a list before you head to your visit.
- Health history notes: It is helpful for your doctor to know the details about your family medical history as well as your own.
- Questions and concerns: It can be hard to remember all the points you want to cover during your visit. So, make a quick list to bring along. Note any symptoms you are experiencing. And do not be afraid to ask your doctor what screenings and vaccines are best for you.
- A buddy: If you have trouble recalling what your doctor says, it might be helpful to invite a trusted family member or friend.
Schedule Your Next Preventive Exam
Stay on top of your health and schedule a preventive exam today. Simply log in to your Coupe member portal or app and use the search tool to find an in-network provider in your community.