Preventative Medicine Coverage

Preventive medicine is aimed at helping healthy people remain healthy, and at
controlling existing health problems before they become more serious. It can
take a variety of forms. Some types of preventive medicine are covered under a
number of health care insurance plans. Employers are increasingly promoting
wellness programs as a means for saving money that can be lost when employees
are sick.
Preventive Medicine Coverage
The following is a list of some of the more common preventive medicine procedures that are covered by some health insurance plans. These procedures are involved with the early detection of health problems:


  • Bone mass measurements, to detect the onset of osteoporosis
  • Cardiovascular screening
  • Colorectal cancer screening. This screening can involve colonoscopy, sigmoidoscopy, and barium enemas.
  • Diabetes self-management training
  • Diabetes screening
  • Glaucoma screening
  • Preventive physical examinations
  • Mammogram screening
  • Medical nutrition therapy. This therapy is mainly for patients with diabetes or renal disease.
  • Prostate cancer screening
  • Screening breast and pelvic exams
  • Screening Pap smear
  • Smoking cessation. Some companies offer bonuses to employees who quit smoking.
  • Vaccinations


Other Preventative Measures
There are several other measures people can take to promote good health. The most common, and most important, are to pursue a healthy diet and exercise program. There are a wide variety of materials online and in bookstores to inform people about how to eat and exercise in healthy ways. A healthy diet along with a healthy exercise program can particularly help with problems associated with obesity, high blood pressure, and high cholesterol. Those materials need to be carefully evaluated. In some cases, it is advisable to seek medical advice about changing the diet or embarking on a new exercise regimen.
Not everything that is advertised as good preventive medicine is actually beneficial. Some supplements and practices that are touted for promoting good health may actually be harmful, or simply ineffective. Consumers need to use care in evaluating health-related claims.
Related Laws
Employers are increasingly offering some form of preventive medicine, or wellness, program. These programs can involve discounts on group health insurance rates, health club memberships, and on-site exercise facilities. In general, these programs are beneficial, but employers need to be careful not to violate any government regulations that may apply.
There are various sections of federal law under HIPAA, ERISA, and the Public Health Service Act (PHSA) that prohibit discrimination in offering health coverage. Wellness programs do not violate these rules as long as the programs qualify as bona fide wellness programs under the definitions provided in the regulations. Employers need to ensure that the regulatory requirements are met. There are also rules against disability discrimination that employers must comply with. In some states, employees can bring lifestyle discrimination lawsuits. Wellness programs may need to be part of a bargaining agreement when unions represent the employees.


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