Understanding Preventive and Diagnostic Care
It's like car maintenance, but 1,000 times more important
June 24, 2024 | Tags:
Taking care of your health is like maintaining a car. You want to avoid problems that could affect performance, and if you notice something is wrong, you figure out what’s causing it. In healthcare, that’s the concept of preventive care and diagnostic care.
Preventive Care
Preventive care aims to avert health issues or detect them before they become significant problems.
“This is similar to routine car maintenance, which keeps your vehicle in peak condition for the best performance,” said Dr. Gail Askew, Assistant Medical Director at Medical Mutual.
Examples of preventive care include screenings like annual well visits, mammograms and colonoscopies. Certain blood tests, like cholesterol and glucose labs, white blood cell count and anemia screenings, are also included. Even vaccinations to prevent illnesses like tetanus, influenza, pneumonia or COVID-19 are considered preventive.
Preventive care is typically covered by your Medical Mutual plan without any out-of-pocket charges when you visit an in-network provider. Refer to your plan’s Certificate Book for coverage details or contact Customer Care at the phone number listed on your member ID card.
Diagnostic Care
Diagnostic care is the care or assessment that occurs when you experience a new health concern.
“Your car’s engine is making a funny clunking noise,” Dr. Askew said. “Much like a mechanic investigating what’s wrong with your car, a physician orders diagnostic care to understand the cause of your symptoms.”
Depending on your symptoms, diagnostic care may include a physical exam, lab tests, biopsies, X-rays, ultrasounds or other scans. How these services are covered depends on the health insurance plan in which you are enrolled.
When “Preventive” Becomes “Diagnostic”
If you bring your car in for an oil change, which is a form of preventive maintenance, and the mechanic finds a hole in the oil pan, they will need to investigate and repair the issue. At that point, you are no longer just paying for a standard oil change.
The same concept applies to healthcare. For instance, if a woman goes in for a routine pap smear, and her doctor finds something of concern during the exam, they may send a specimen to the lab for further investigation. In this case, that lab test is considered diagnostic because it is investigating an unexpected problem. However, the initial pelvic exam is still covered as preventive care.
Make an Appointment
Contact your primary care physician (PCP) to schedule your preventive screening today. If you do not have a PCP, Medical Mutual can help. Click the button below to use the provider search tool or call Customer Care.