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The Financial Risk of Avoiding Regular Health Checkups

The Financial Risk of Avoiding Regular Health Checkups

By Tuesday, 24 November 2020 02:14 PM Current | Bio | Archive

The medical system is a distinct cause of stress for many Americans. Insurance policies can be difficult to navigate, and coverage limits can be hard to understand. Many of us process this medical system stress by avoiding what we perceive to be unnecessary trips to the doctor.

Unfortunately, it’s not just necessary or recommended procedures that we tend to skip. A large percentage of Americans also avoid low-cost routine checkups. Apprehension around doctor visits is normal, but skipping regular checkups can lead to higher medical costs down the road.

Why do we avoid health checkups?

Tens of millions of Americans avoid scheduling doctor visits for a variety of reasons, although much of that is rooted in a confusion over how medical insurance works. When we aren’t sure how much we’ll ultimately have to pay and don’t fully understand where to find that information, we avoid going to the doctor unless absolutely necessary.

Consequently, large swaths of Americans don’t know how to properly define critical health insurance policy terms. For example, the amount you pay out of pocket — your deductible — determines whether you should expect a bill following a visit to the doctor. Yet 57% of Americans can’t define what an “out-of-pocket maximum” is, and 54% are confused about deductibles. Additionally, nearly half (48%) can’t define the word “copay.”

The U.S. Census Bureau reports that 92% of Americans now have health care coverage. Despite this increasingly wide access to insurance, though, 22% of Americans avoid doctor visits, mostly due to concerns over costs.

Those concerns are not completely unfounded for many types of medical procedures, especially for Americans with high-deductible health insurance policies. But it’s certainly not true for annual checkups under most insurance plans. In fact, a Cigna study reports that 50% of Americans don’t realize that annual checkups are free through most health insurance policies.

Cost of delaying checkouts

Regular health checkups may take some time out of your schedule, but they can help save thousands of dollars in the long run. Individuals who have more frequent medical checkups also have lower health care expenses years later.

Diabetes offers a case study in the importance of annual health checkups. Those with prediabetes tend to have far lower health care costs than those who later develop diabetes.

One study found that people with diabetes spend over 30% more on medical care than those without it.

The American Diabetes Association estimates that 88 million Americans have prediabetes, many of whom avoid regular checkups that could help lead to a life- and cost-saving diagnosis essential in preventing the development of Type 2 diabetes.

How to save with health checkups

Regular checkups are a form of preventative medicine. They allow your doctors to spot early warning signs of dangerous health conditions. The sooner you know about health problems, the easier it is for your doctor to treat them and the less you’ll have to pay in health care expenses.

Before you call your doctor to schedule an exam, however, make sure you’re properly covered — your insurance provider may not cover every type of medical screening or annual checkup. While most low-cost health insurance policies cover basic health screenings, coverage limits vary.

Some higher out of pocket plans might be the most cost-effective in the long run, as you are able to reach the deductible quickly then you have access to coinsurance through your provider.

In California, for example, they have approved Medicaid coverage for anyone with a household income below 138% of the federal poverty level. This covers annual wellness visits but by law does not cover physical exams. If you call your doctor and ask for your physical exam, you’ll get one, but you may have to pay several hundred dollars out of pocket if you use the wrong terminology when scheduling the exam.

That said, the Affordable Care Act (ACA) requires insurance providers to cover 100% of the cost of an annual wellness check once every 365 days. The key term to use is “annual wellness check,” which will ensure your doctor knows that you are asking to receive this federally mandated preventative service. When you go in for your annual wellness check, your doctor will deliver several preventive care services, including checking your blood, screening for diabetes and screening for obesity. You’ll also receive a physical and emotional well-being check.

Your timid feelings about doctor visits may not subside anytime soon, but at least your financial worries are taken care of. Thanks to the ACA, your health insurance provider will cover 100% of the cost for an annual wellness check. All you need to do is call your doctor to schedule an appointment.

Maxime Rieman is Product Manager at ValuePenguin. Educating and assisting shoppers about financial products has been Rieman's focus, which led her to joining ValuePenguin, a consumer research and advice company based in New York. Previously, she was product marketing director at CoverWallet and launched the personal insurance team at NerdWallet.

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The medical system is a distinct cause of stress for many Americans. Insurance policies can be difficult to navigate, and coverage limits can be hard to understand. Many of us process this medical system stress by avoiding what we perceive to be unnecessary trips to the doctor.
financial, risk, avoiding, regular, checkups, health
Tuesday, 24 November 2020 02:14 PM
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