Before you think about health benefits for next year, use the ones you have already. You don’t have to wait until you or your family members are sick.
Visiting your health care providers when you are well can help with early detection and treatment of illnesses and diseases. Plus, these preventive exams can help you assess your family’s health and health care needs, which can help you determine what health insurance and health benefits plans to buy in the future.
Before you choose health benefits for 2016, whether through your employer or Obamacare open enrollment, make sure you schedule these preventive health care appointments:
1. Wellness exam
An annual wellness exam or physical allows you and your primary care doctor to touch base about your overall health and talk about any changes that may be in order related to your lifestyle, prescription medications or current treatment plans for health conditions. A routine physical may vary slightly from physician to physician. In general, however, the appointment will include:
- Height, weight and blood pressure measurements
- A head to toe exam that includes listening to your heart and lungs; checking your ears, nose and throat; looking at your skin and more
- Updates to your health history
- Discussing your health habits and lifestyle, as well as health concerns you may have
Depending on your gender, age, family health history and other risk factors, your doctor may perform additional examinations and order laboratory tests.
Under the Affordable Care Act, major medical health insurance plans that qualify as minimum essential coverage must include many preventive care services at no cost—this does not apply to grandfathered health insurance plans or plans that are not subject to the Affordable Care Act, such as short term health insurance. Check your health insurance policy to confirm your preventive care benefits, and contact your health insurance company’s member services department with specific questions.
2. Dental exam and cleaning
Preventive dental care is important for many reasons, namely keeping teeth and gums healthy. The American Dental Association lists regular dental visits for professional cleanings and oral examination among the key ways to prevent tooth decay and gum disease.1,2During these visits, you and your dentist will also discuss any oral health concerns you may have and additional oral care you may require in the future.
How often should you see a dentist for routine dental care? It depends on your oral health needs. As the ADA states, some people need to visit the dentist once or twice a year, while others need to go more frequently.3 Ask your dentist what he or she recommends for you.
While dental insurance benefits vary, many dental plan benefits cover two preventive exams and cleanings per calendar year. Because dental insurance emphasizes preventive care, a lot of dental insurance plans (including those sold to individuals and families as well as those available through an employer) cover preventive services at or close to 100 percent. Check with your dental insurance plan to confirm your current benefits.
3. Vision exam
A comprehensive eye exam is another important part of preventive health. This preventive visit to an eye doctor such as an optometrist or ophthalmologist will include an assortment of tests to evaluate vision and eye health. You and your eye doctor will also discuss your health history and any vision or eye health concerns you may have. Eye exams can also help detect diseases and health problems such as diabetes and high cholesterol.4
The American Optometric Association recommends an eye exam every two years for asymptomatic or risk-free children ages 6 to 18 and adults age 18 to 60.5 Adults 61 and older, as well as at-risk children and adults, should visit the eye doctor annually. For children younger than age 6 years old, the AOA advises an eye exam at 6 months and 3 years and more frequently as recommended.
Again, visiting the eye doctor will provide helpful information about your health care needs—information you should keep in mind when it’s time to buy 2016 health insurance coverage and plan for annual health care expenses. If you do not have vision insurance, consider shopping for a dental plan that includes a vision discount program.
Preparing 2016 open enrollment
These annual preventive care visits can help you determine what major medical health insurance coverage and supplemental benefits (e.g., dental, vision) you should buy for 2016.
Take note of the following and consider it when shopping for a health plan during 2016 open enrollment:
- Concerns your doctor, dentist or eye doctor has about your risk for illness or disease
- Recommendations for follow-up care or ongoing care
- Screening and test results
- New prescriptions for medication(s)
Just because your health insurance benefits met your health care and financial needs this year does not necessarily mean you should buy the exact same coverage next year. Your health and health risks may change. Your health or dental insurance plan’s network and benefits may change. Companies and plans exit the market. Assess your current coverage. Shop around to see what else is available, and read plan details carefully—both for the coverage you might renew and other options you are considering.
If you need help making decisions or finding the right health, dental or vision benefits, contact your health insurance agent or broker.