Reuters Money

Dr. Therese Bevers (l) is pictured in this handout photo. REUTERS/Handout/University of Texas MD Anderson Cancer Center

Dr. Therese Bartholomew Bevers has met a lot of worried women while working as the medical director of the cancer prevention center at M.D. Anderson Cancer Center in Houston. Many patients there face a high genetic risk of breast cancer, and they  just want to talk to a doctor about their many options for preventing the disease. But that can be expensive. “If they have to pay out-of-pocket for counseling, price becomes a deterrent,” Bevers says.

As of this year, price will no longer be a hurdle when it comes to preventative healthcare. That’s because the health reform legislation requires insurance carriers to waive co-pays and other fees that they used to charge for many services that are designed to keep people healthy. Specifically, the law bans cost sharing for services rated “A” or “B” by the U.S. Preventive Services Task Force (USPSTF); immunizations recommended by the Centers for Disease Control and Prevention; and suggested screenings from the Health Resources and Services Administration.

Free is always good, and for some patients it may even be lifesaving. For example, women no longer have to pay for annual cervical cancer screening or testing for sexually transmitted diseases. Pregnant women can get a host of free preventive tests, plus counseling on how to breastfeed. And all women can get mammographies and genetic testing for the BRCA breast cancer gene. Bevers believes many of these newly free services will help women and their doctors to become smarter about preventing disease. “It’s critical that we make recommendations based on levels of risk,” Bevers says.

Medicare patients can also get a host of new services at no charge. In addition to receiving a “Welcome to Medicare” physical exam, seniors can now receive an annual wellness visit, plus a personalized prevention plan–all for free. The prevention plan includes tests for cognitive impairments, a list of disease risks and recommended interventions, and a ten-year plan for staying healthy.

The USPSTF also recommends that men between the ages of 65 and 75 be screened for abdominal aortic aneurysm–a ballooning of the vital blood vessel that supplies the abdomen, pelvis and legs. If the aneurysm bursts, it can be deadly. Preventing such a complication by getting a picture taken of the aorta is simple, says Gary Rogg, an internist at Montefiore Medical Center in the Bronx, NY. “It’s a very safe, non-invasive ultrasound,” Rogg says. If the test detects an aneurysm that’s about to burst, doctors can correct it with surgery. “There’s zero downside to going for this test,” especially now that it’s free, Rogg adds.

High cholesterol can contribute to aortic aneurysms, which is why it’s good news that cholesterol screening and dietary counseling are included on the USPSTF’s list. Also included is comprehensive nutritional counseling for children who are obese.

Some experts hope the cost savings will encourage more patients to be vigilant about their health risks. Last August, the Midwest Business Group on Health (MBGH) released results from a survey in which a staggering 88 percent of employees confessed that they didn’t understand the value of preventive health services. More than 55 percent said they weren’t motivated to stay healthy, and 47 percent confessed they were reluctant to take time out of their work day to get health screenings.

“Employers have to find ways to motivate their employees” to take advantage of free preventive services, says Larry Boress, president and CEO of MBGH. “Many employers offer these great wellness programs, but they never communicate them to employees or their families. The communication has to get to the whole family.”

In response to the new law, major carriers such as UnitedHealthcare have posted lists of tests and other services that are now offering free of charge. Boress says several employers are also testing programs in which they dole out financial rewards to employees who participate in preventive-health programs.

Before rushing to make appointments for all these screenings and check-ups, though, it’s important to keep some caveats in mind. If you signed up for a “grandfathered” health plan–meaning your employer is allowing you to stick with a policy you had before health reform was passed–you may not be able to get preventive services for free. That’s because the rules don’t apply to grandfathered plans.

If you have a newer plan, but it’s one that requires you to pay a flat co-pay for office visits, you might have to pay something if you see a doctor when you go in for the test. Say, for example, you visit the doctor complaining of sniffles and he reminds you that you’re due for a cholesterol test. Even though the test is free, you may have to hand over a co-pay for consulting with the doctor about something else.

The best course of action: Review the lists of preventative services that now qualify for the health reform subsidy and then call your doctor to discuss which ones you should be having–and which of those are free. As the old saying goes, it won’t cost you anything. And it may make you healthier in the long run.