{"id":20111,"date":"2023-01-12T17:13:15","date_gmt":"2023-01-12T22:13:15","guid":{"rendered":"https:\/\/www.zocdoc.com\/blog\/?p=20111"},"modified":"2023-03-17T14:06:14","modified_gmt":"2023-03-17T19:06:14","slug":"what-the-most-common-doctors-appointments-cost","status":"publish","type":"post","link":"https:\/\/www.zocdoc.com\/blog\/guides\/what-the-most-common-doctors-appointments-cost\/","title":{"rendered":"Your Guide to Preventative Care Appointments: Costs and More"},"content":{"rendered":"

Can an apple a day keep the doctor away? Probably not; however, staying away from the doctor\u2019s office can feel like a money-saving measure. But did you know that you\u2019re legally entitled to a number of free health screenings and vaccinations each year?\u00a0<\/span><\/p>\n

Under the Affordable Care Act, most insurance policies, including Medicaid and Medicare, are required to offer certain preventive healthcare services at no cost to you \u2014 with a couple of disclaimers, which we\u2019ll discuss below. <\/span>
\n<\/span>
\n<\/span>If you don\u2019t have insurance coverage, many services are still available for free or at heavily discounted rates through community clinics, local nonprofit organizations and other places. As we enter a new year, here are several types of doctor\u2019s appointments that are typically fully covered.<\/span><\/p>\n

\n

What\u2019s a preventive service and why do we need them?<\/h3>\n

Chronic conditions, many of which are preventable, cost the US hundreds of billions of dollars a year. Almost 6 in 10 Americans today live with at least one chronic health condition and nearly 30 percent struggle with three or more, according to <\/span>2017 research<\/span><\/a> from the nonprofit RAND Corporation.\u00a0<\/span><\/p>\n

Preventive screenings<\/span><\/a> can improve overall health, identify acute diseases, prevent or detect cancer at earlier stages and help patients address conditions like obesity or high cholesterol sooner rather than later.\u00a0<\/span><\/p>\n

\u201cEarly detection and prevention through regular check-ups can save you a lot of money and discomfort down the road,\u201d says Dr. Amy Faith Ho, a Dallas-based emergency medicine physician. \u201cTreating a medical problem is both onerous and expensive, but preventing a medical issue before it becomes a problem is often simple and free.\u201d<\/span>
\n<\/span><\/p>\n

In fact, the Patient Protection and Affordable Care Act (ACA) requires private insurance providers to offer access to <\/span>preventive services<\/span><\/a>. These services must be offered without cost-sharing, which means your insurance company cannot charge you a coinsurance or copay.\u00a0<\/span><\/p>\n

These services include:<\/span><\/p>\n

    \n
  1. Preventive services with an <\/span>\u201cA\u201d or \u201cB\u201d grade rating<\/span><\/a> by the US Preventive Services Task Force (USPSTF)<\/span><\/li>\n
  2. Routine vaccines for adults and children<\/span><\/a> recommended by the Advisory Committee on Immunization Practices (ACIP)\u00a0<\/span><\/li>\n
  3. Preventive services for infants, children and teens<\/span><\/a> recommended by the Health Resources and Services Administration (HRSA)\u00a0<\/span><\/li>\n
  4. Women-specific care and screenings<\/span><\/a> recommended by the HRSA<\/span><\/li>\n<\/ol>\n
    \n

    Let\u2019s break these preventative screenings down\u2026<\/h2>\n

    Your annual physical<\/h3>\n

    These are some standard preventive screenings and health metrics that you and your primary care provider should track on a regular basis. Your doctor will typically go over these benchmarks, including by taking various blood pressure and cholesterol levels, in <\/span>an annual physical.<\/span><\/a>\u00a0<\/span><\/p>\n

    Depending on your health habits and family health history, your PCP may order some additional tests or screenings, such as a colonoscopy if you\u2019re at high risk for colon cancer, which may be covered as preventive care. If your results come back clean, you will likely be asked to repeat the exam at a later date, which should also be covered under preventive care.\u00a0<\/span><\/p>\n

    If you don\u2019t have a PCP or can\u2019t get a timely appointment with your usual doctor, you may be able to reach out to your regional clinic or community health center, which may be able to accommodate you more quickly. As always, be sure to confirm that the facility you visit is in-network with your insurance provider to avoid paying for your visit out of pocket. Physicals <\/span>can range anywhere<\/span><\/a> from $100 to $300 out of pocket.\u00a0<\/span><\/p>\n

    Ob-gyn checkups<\/h3>\n

    People with uteruses are eligible for annual wellness checks under the ACA. Most health insurance plans will cover one visit each year, and uninsured people can often access care through Planned Parenthood or local community health centers at no or reduced cost.\u00a0<\/span><\/p>\n

    Here\u2019s<\/span><\/a> what you can expect at a visit with an ob-gyn.\u00a0\u00a0<\/span><\/p>\n

    Pregnancy treatment<\/h3>\n

    Private health insurance and Medicaid cover preventive services for pregnant people. (More than 40 percent of pregnant people in the US are covered by Medicaid, according to <\/span>Planned Parenthood<\/span><\/a>.)<\/span><\/p>\n

    If you\u2019re pregnant, these appointments are typically covered:\u00a0<\/span><\/p>\n