Dr. Linette Williamson - Preventive Health in Encinitas, California

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What Is Preventive Care?

Preventive care helps discover or prevent serious illnesses and medical problems before they can become serious. Annual check-ups, immunizations, and flu shots, along with certain tests and screenings, are a few examples of preventive care. This might also be called routine care.

What's the difference between preventive care and diagnostic care?

Diagnostic care is related to services in which your provider is looking for something specific, typically based on the results of a preventive test or screening. For example, a radiologist might ask for a follow-up mammogram for an individual. This follow-up is to check for something that may have been detected during the preventive or routine mammogram. The follow-up mammogram is diagnostic, and not covered as preventive care.

What are preventive care services?

Examples of preventive health services and their frequency:

• Annual check-up (1 per calendar year) – This is when your Primary Care Provider (PCP) checks all areas of your health – physical, as well as psychological. This can help discover any health concerns early, before they turn into major medical issues.
• Flu shot (1 per year) – This is usually covered 100% under most health plans and helps protect you from certain strains of the flu virus.
• Mammogram (1 per calendar year, usually after the age of 40) – Routine X-rays of breast tissue to check for any signs of cancer or other abnormalities. Some health plans may also cover costs for 3D imaging.
• Colonoscopy (usually 1 per every ten years, generally after the age of 50) – Screening for colon cancer.
• Vaccinations (normally administered during childhood, including boosters as needed)-- Vaccinations like measles, mumps, rubella, polio, etc. are covered at 100%.

Examples of non-preventive care include:

• Diagnostic tests and screenings– These are not routine tests and screenings. For instance if your radiologist finds something on your mammogram and wants another, it's considered a diagnostic mammogram and will generally not be covered as preventive care.
• Additional primary care visits– Most health plans will cover you for 1 annual check-up with your doctor. Other visits during the same calendar year will likely not be covered as preventive. For example, let's say you have flu symptoms and need to see your physician-- that's not a covered preventive care visit.
• Specialist visits– Visits to a specialist (gastroenterologist, orthopedist, neurologist, podiatrist, etc.) for a specific problem are not covered as preventive care.
• Alternative therapies– Services such as chiropractic, massage, acupuncture, and various other alternative health services are not considered preventive care.
• PSA blood test– This is a test to check for prostate cancer. Some health plans may cover this as preventive care, but several do not.

Is preventive care free?

Most health plans are required by law to cover eligible preventive care services at 100%. This includes health insurance plans you get through your employer along with those you might purchase on your own through the Health Insurance Marketplace. Your physician must also be in-network in order to be completely covered.

What are the benefits of preventive care?

Preventive care is intended to help you stay as healthy as possible. Routinely scheduled visits and tests allow your doctor to detect any medical problems before they can become major.

Benefits of preventive care include:

• The majority of preventive care at no cost to you as part of your health coverage
• Early detection of medical problems, illnesses, and diseases helps your doctor offer proactive care and treatment
• Routine care can help you remain focused on your own health goals

How do you know what preventive care you need and when?

Your primary care provider can help you determine what tests and shots are right for you. They may look at factors like family history, age, sex, current health status, and more.

Preventive care is usually covered 100% by your health plan and offers many benefits, both in cost and health. If you have concerns about what's covered and not covered, or when you should have particular tests done, make sure to ask your physician.

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Linette Williamson, MD is an Integrative Medical Doctor, who specializes in helping her patients and Preventive Health in Encinitas, California

Identify lifestyle factors that affect their everyday medical issues. Dr. Williamson uses cutting-edge testing to find imbalances that are related to your health problems. She will spend time with you to find out what specific issues you have and help you develop a specific plan that is unique to you.

Call the clinic and schedule your appointment now. Phone (760) 875-2627