Keeping yourself healthy can sometimes feel like a juggling act. This can be especially true as we begin to age. If you’re like most adults, you probably already have a few tricks up your sleeve for trying to feel your best, like eating right, drinking more water, getting enough exercise and resting more.
But what about going to the doctor regularly? To stay in tip-top shape, keeping up with preventive and routine care can be just as important as anything else on our to-do lists.
Sorting out the terminology
Staying up-to-date with preventive services is an important piece to your health care puzzle. But understanding the difference between the kinds of care you should be receiving might be a little confusing.
What constitutes preventive care? Generally speaking, preventive care services are ones you get when you’re healthy to keep you feeling healthy. These can include things such as:
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- Annual wellness visits.
- Age-appropriate cancer screenings.
- Blood pressure or cholesterol screenings.
- Standard immunizations.
Depending on your benefits plan, these can sometimes be covered at 100 percent, or you may be responsible for paying a portion of the cost. It all depends how your individual plan is laid out.
A few other factors, such as whether your provider is in-network or out-of-network, can come into play, as well. To keep it straight, it’s best to read through your benefits booklet or summary plan description (SPD). To see a comprehensive list of more preventive services, you can go to the Department of Health and Human Services website at www.healthcare.gov.
To learn more about distinguishing between preventive, diagnostic and routine care, check out our video. This will help you start to add appropriate care into your health care regimen.
What comes next?
So, once you’ve got a firm handle on your preventive services, you might be wondering what comes next? If your doctor uncovers an issue during one of your appointments, or you’re suddenly feeling under the weather, you might need some follow-up visits to get to the root of what’s going on. If this happens, you might be sent for diagnostic care.
This type of care is for monitoring or diagnosing a medical condition. It can include any doctor’s visits or tests you need to evaluate your symptoms and get you back on your feet. Some common examples include things such as: X-rays, MRI, CT scan or biopsy. These are just a few tools your doctor might use, but when in doubt it’s best to consult your benefits plan or provider’s office to know how certain visits are categorized.
Ongoing and routine care
When you’ve established some healthy habits like visiting your health care providers on a regular basis, you might then need some ongoing care. This is usually referred to as your routine care. These are services beyond simply preventive and might be ones you require based on your age or gender. Mammograms and colonoscopies are two familiar examples.
Putting it all together
Still a little confused? That’s okay! Sometimes even after studying up, understanding the differences between various health care services and how they fit in to your benefits package can be tough to understand.
At Meritain Health®, we strive to make it simpler. As your Advocates for Healthier Living, we have lots of tools for educating members on their benefits. You’ll be able to plan for cost-sharing, coverage limitations and any bills you may receive.
Contact Meritain Health with questions
If you have questions, we have answers! Meritain Health members can simply call Customer Service by using the number on the back of your ID card.
This article is for informational purposes only, and is not meant as medical advice.
