Preventive Care
It’s important to see a primary care physician for a preventive care visit each year. Especially if you're healthy and want to stay that way.
Overview
What is preventive care?
Preventive care includes things such as regular check-ups, screenings and immunizations. It may be covered without cost-sharing when you visit a doctor that is in your health plan’s network. This type of care may also help you catch health problems before they become serious. Talk to your doctor about what care is right for you.*
Why is it important?
Having a preventive visit allows your doctor to evaluate your health and make sure you get the right screenings for your age, gender and family history. This visit can help you stay healthy and may help you identify health concerns before they become a long term condition.
What’s the difference between a preventive visit and an office visit?
Preventive visits, sometimes called a routine check-up, are different than an office visit scheduled to discuss a specific medical problem.
You would see your doctor, nurse practitioner or physician’s assistant for a preventive visit when you feel healthy. It may include care like an exam, checking your blood pressure, or getting recommended vaccines. These visits may be covered without cost-sharing when you use an in-network provider (doctor, nurse practitioner, physician’s assistant).
Office visits generally include checking on symptoms to treat a specific medical condition or problem.
Coverage
How is preventive care covered?
Many Blue Cross plans cover preventive care services without cost-sharing when you see a doctor that is in your health plan’s network. Be sure to check the details of your plan before you make an appointment with a doctor.
Sometimes, your doctor will order tests during your preventive care visit that are not considered preventive care. These tests may be subject to deductibles, copays and/or coinsurance.
Your doctor may also treat an existing condition (or you may have symptoms of an illness at the time of your visit). Treatment or tests for that existing condition are not preventive care and are subject to deductibles, copays and/or coinsurance.
Preventive Care Resources
It’s important to understand what’s medically recommended and what your specific plan covers. Use these resources to research. Find additional details in your benefit booklet.
What to expect
What to expect at a preventive care visit
At your preventive visit, your primary care doctor will likely ask you about your current health, your family history, past illnesses and surgeries and chronic conditions to assess your health risk. They will also likely do a physical exam, such as checking your vital signs, listening to your heart and lungs with a stethoscope, checking your ears, eyes, throat, skin, abdomen etc.
Your doctor may conduct screenings specific to your age and gender:
Children ages 0-5
Children ages 6-12
Women
Seniors
How to prepare for your next physical exam
You’ll want to prepare for your physical exam by completing any forms in advance, making a list of medications you take regularly and identifying any additional questions and concerns.
Find primary care
A primary care physician is a health care professional you see for a physical exam or preventive visit and the doctor you go to regularly for health care.
Choose a doctor you trust and then see that same doctor over time so your health care is consistent and coordinated.
Prepare questions
Concerned about symptoms or confused about changes in your health? Ask questions like these:
- What might be causing this problem?
- What are the treatment options for addressing this problem?
- What are the side effects of the medication you’re prescribing?
- How will I know if the treatment is working?
- When should I see you for follow-up?