And then what?

The America’s Health Insurance Plans is patting itself on the back for discovering that the majority of high-deductible health plans, which are connected to Health Savings Accounts, cover recommended preventive benefits — meaning that patients can go in and get pap smears, well-baby visits, colonoscopies without having to pay full price for the office visit.

Okay..that’s a good start. But what happens when your preventive screening shows you have Diabetes? Asthma? Breast Cancer? Then what?

Herein lies the problem. Actually, there are a couple problems.

First, while more than 90% of HSA-eligible plans offered through employers covers preventive care — most of these plans are purchased through the individual market. There, only 59 percent of policies offer preventive care, meaning that 41 percent of those with these plans don’t have preventive coverage.

Secondly, in consumer-speak, “preventive care” means not only the preventive screening for diabetes, but it also means coverage for insulin shots and other medications to “prevent” further illness. In the industry, however, it’s called “chronic disease maintenance,” which is NOT covered.

So consumers may be buying these plans believing that they’ll have coverage for all their meds and follow up doctors visits because it includes “first-dollar coverage for preventive care” but it’s not the care they think it is.

I’m looking forward to the press release from AHIP that says 100% of plans pay to keep people healthy.

Health Access California promotes quality, affordable health care for all Californians.

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