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THE WAY TO WELLNESS

UT SELECT Medical now provides 100% coverage for Preventive Screenings

Free Preventive Care and Services – The UT SELECT Medical plan has always offered robust preventive care benefits including 100% preventive colonoscopy and no cost immunizations for children under 6 years of age. Now, certain additional preventive care and services will be available to you with no copayment or coinsurance as long as you see a network provider and meet certain screening eligibility requirements. Some examples of services covered under this provision include:

Please be aware that you may incur some cost if the preventive service is not the primary purpose of the visit or if your doctor bills for services that are not preventive. Eligible services are outlined in the Federal Regulations based on U.S. Preventive Service Task Force Recommendations. You may find more information about the covered preventive services at www.healthcare.gov/news/factsheets/2010/07/preventive-services-list.html.

The Wellness Guide to Preventive Care

A recent government study showed that more than half of all Americans do not receive many of the important preventive services they need—that is, immunizations, screening tests for early detection of disease, and education about healthy habits and injury prevention. Why not?

With tests for some cancers, there's the embarrassment factor. Some people may dread being tested for colon, prostate, or breast cancer and be relieved if the doctor fails to mention it. Some people would rather not know.

Both doctors and patients may be confused by contradictory recommendations. What should a medical checkup consist of? Does everybody need an annual physical? Should all men get a PSA test? At what age should a woman start having mammograms? (See below for answers to such questions.)
Doctors may fail to ask patients about smoking and drinking, not to mention exercise habits and diet. Some HMOs don't encourage their doctors to counsel people. Some doctors think their job is to treat illness, not prevent it.

The watchword among insurers now is cost containment. Yet medical technologies and consumer demand for services are expanding daily. Thus, we all have to make choices. Will patients in a big HMO get more benefit from an additional MRI machine or from having their doctors take time to counsel them about exercise and a heart-healthy diet? The new MRI machine will be easier to justify, in terms of immediate, measurable benefits.

How about that annual physical?
It used to seem simple: people were advised to undergo a standardized annual or biannual "complete physical." But in the 1980s, at the request of the government, an independent committee of physicians known as the U.S. Preventive Services Task Force reviewed all evidence and evaluated the benefits and drawbacks of common screening tests and came up with recommendations. (A similar group, the Canadian Task Force on Preventive Health Care, does the same work in Canada.) That head-to-toe physical exam has now been discarded for seemingly healthy people, since it yields too few benefits for its cost. Over the long run, it doesn't pay off in terms of better health and longer life.

The US Preventive Task Forces continue to update and re-evaluate their advice, reviewing thousands of studies every year and consulting hundreds of scientific reviewers.

Article Source:  The National Coalition on Health Care. www.nchc.org.