Understanding Preventive vs. Medical Care

There are two types of care you can receive when you go to the doctor – preventive care and medical care. The care you’re provided is different and so may be the cost.

Even if you feel healthy, once a year you should get a preventive checkup from your doctor.
Preventive care may help you avoid some health problems, or find health problems early, when your chances for treatment and cure are better.

  • It can catch disease early and may lead to better health outcomes and lower costs.
  • Six in 10 American adults have a chronic disease. Four in 10 have four or more chronic diseases.
  • These diseases are a leading cause of death and disability in the U.S. These conditions are preventable or treatable in many cases.

Yearly preventive exams and screenings may include:

  • A physical exam
  • Screenings for things like blood pressure and cholesterol levels
  • Vaccines you need to prevent illness
  • Mammogram screening
  • Colon cancer screening
  • Cervical cancer screening
  • Diabetes screening

There are both “screening” and “diagnostic” versions of many tests, such as mammograms and colonoscopies.

A screening version is considered preventive care. Preventive screenings are usually ordered at certain ages and at regular intervals when there is no reason to suspect a problem.
If a person has symptoms or anything looks unusual on a screening test, they may need a diagnostic test, which is considered medical care. Diagnostic tests take a closer look to see if disease is present.

The technology for diagnostic and medical tests may be similar. But where and when you take them and who reads the results are different. The out-of-pocket costs may also be different.
It’s a good idea to find out what your out-of-pocket costs will be before you schedule your appointment.

You can help control your out-of-pocket costs by checking with your doctor’s office to see which kind of test you’ll get and check your benefits or call the customer service number on your member ID card to get the details about your coverage and costs for the test.