As the name suggests, preventive health care cover is a plan that provides coverage for the care that needs to be taken to prevent the onset of diseases. Previously, preventive care was covered by health insurance plans at different levels and depended on the insurance providing company. However, at present, the insurance companies are mandated by law to cover the costs of preventive doctor’s visits and diagnostic tests without any addition to the premium of a health plan.

What is covered under preventive health care cover?

Preventive health care services can be categorized into the following three segments:
  • For adults
  • For women
  • For children
Each category has its own list of preventive services as discussed below.

Preventive health care services for adults

  • Screenings: For abdominal aortic aneurysm, alcohol misuse, blood pressure, cholesterol, colorectal cancer, depression, type-2 diabetes, hepatitis B, hepatitis C, HIV, lung cancer, obesity, syphilis etc.
  • Medications: Aspirin for prevention of cardiovascular diseases
  • Immunisations: For hepatitis A, hepatitis B, influenza (flu shot), human papillomavirus (HPV) etc.
  • Counselling: For alcohol misuse, obesity, diet, sexually transmitted infection (STI) prevention, smoking cessation intervention etc.

Preventive health care services for women

All women Pregnant women
Breast cancer genetic test counselling Anemia screening
Breast cancer mammography screening Breast-feeding comprehensive support and counseling
From Rs. 5,00,000 - 7,50,000     20%
Breast cancer chemoprevention counselling Gestational diabetes screening
Cervical cancer screening Hepatitis B screening
Chlamydia infection screening Syphilis screening
Domestic and interpersonal violence screening and counselling Urinary tract infection (UTI) screening
Gonorrhea screening Tobacco intervention and counselling
HIV screening and counselling Rhesus factor (Rh) incompatibility screening and follow-up testing
Human papillomavirus (HPV) DNA test Folic acid supplements
Osteoporosis screening Breast-feeding supplies for nursing women
Sexually transmitted infection (STI) counselling Education and counselling on Food and Drug Administration (FDA)-approved contraceptive methods and sterilization procedures
Syphilis screening
Tobacco use screening

Preventive health care services for children and adolescents

  • Screenings: For autism, blood pressure, cervical dysplasia, depression, development, dyslipidemia, hearing, vision, height, weight, Body Mass Index (BMI), hematocrit/hemoglobin, hemoglobinopathies/sickle cell, hepatitis B, hypothyroidism, lead and arsenic in blood, obesity, phenylketonuria (PKU), oral health, sexually transmitted infection (STI), tuberculin, alcohol and drug use etc.
  • Medications: Iron supplements for children aged between 6-12 months at the risk of anemia, gonorrhea preventive medication to protect the eyes of newborns, fluoride chemoprevention supplements for children without fluoride in their water source etc.
  • Immunisations: For diphtheria, tetanus, pertussis (whooping cough), hepatitis A, hepatitis B, influenza (flu shot), human papillomavirus (HPV) etc.
  • Counselling: For obesity, sexually transmitted infection (STI) prevention, smoking and drinking intervention etc.

Hence, while buying a health insurance plan, you must make sure that your insurance provider is offering you as well as your dependants (spouse, children, parents) preventive health care services within your plan’s network of health service providers without any extra charge.

Learn more about different Health Insurance Plans here.

DISCLAIMER

The information contained herein is generic in nature and is meant for educational purposes only. Nothing here is to be construed as an investment or financial or taxation advice nor to be considered as an invitation or solicitation or advertisement for any financial product. Readers are advised to exercise discretion and should seek independent professional advice prior to making any investment decision in relation to any financial product. Aditya Birla Capital Group is not liable for any decision arising out of the use of this information.



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