Health care is about more than getting treated when you’re sick. It’s important to take action to prevent getting sick, too.

1. What are preventive screenings?
2. Are preventive screenings covered by insurance?
3. What preventive screenings do I need?
4. What preventive services are recommended for all adults?
5. What preventive services are recommended for women?
6. What preventive services are recommended for men?
7. What other preventive screenings are important?

Have you heard the old saying “an ounce of prevention is worth a pound of cure”? When it comes to your health, it’s true — it’s much easier to prevent chronic diseases such as heart disease, cancer and diabetes than it is to cure them.

Measures such as preventive screenings can save your life. They can save you money, too. Preventive screenings are often covered by insurance at a low or no cost to you. And they can catch problems early when they are easier (and less expensive) to treat.

Here’s what you need to know about the screenings that can increase your odds of staying healthy longer.

A comprehensive health plan can also help you stay on top of your health by helping you pay for regular care. Enter your zip code to find available plans, or call a licensed insurance agent at 1-844-211-7730.

What are preventive screenings?

Preventive screenings are types of medical tests recommended for certain groups of people, even if you’re feeling fine. They are a way to check for health problems before you start showing signs and symptoms. (Diagnostic tests, on the other hand, are used to figure out what’s causing a problem after you’re showing symptoms.)

“Screenings are a powerful tool that helps you stay ahead of the curve and in the ‘driver’s seat’ of your health and wellness,” says Cecily Havert, M.D., who’s with Northern Virginia Family Practice in Alexandria, Virginia. “I liken it to being proactive rather than reactive.”

For example, a mammogram on one of her patients recently revealed an early-stage breast cancer that a clinical exam couldn’t detect. “I was able to get her in to see the breast surgeon quickly, who removed the tumor in its entirety, which is hopefully curative for this patient,” Dr. Havert says. “If we had waited until we felt a mass in her breast, it may have been too late to offer such a successful and relatively simple treatment option.”

Some preventive screenings, such as a blood pressure screening, take place in your doctor’s office. Others, such as a colonoscopy, require a trip to a lab, hospital or outpatient surgery center.

Screenings don’t always involve poking and prodding. Some involve asking questions about things such as sexual activity, signs of depression or tobacco use. “The fact that you tell us that you smoke cigarettes means we can do something about that,” says Robert W. Amler, M.D. He’s dean of the School of Health Sciences and Practice at New York Medical College and a practicing physician.

Are preventive screenings covered by insurance?

Whether preventive screenings are covered by insurance depends on where you get your plan. Health plans that are governed by the Affordable Care Act must cover preventive care at no cost (as long as it’s done by a provider in your plan’s network). That includes health plans offered by small employers as well as individual health plans purchased through a marketplace.

Medicare also covers preventive care, although you may be responsible for out-of-pocket costs. Coverage under other plans, such as employer-sponsored plans, can vary. The best way to know for sure if a preventive screening is covered is to contact your health insurance company.

If a screening test finds a potential problem, your doctor may want to do further diagnostic tests. Keep in mind, while the screening may be covered at no cost, you may have to pay a copay or coinsurance for additional testing. The same is true of any care you may need to treat the problem.

Got questions about the Affordable Care Act? Get more details now or call a licensed insurance agent at 1-844-211-7730 to discuss your options.

What preventive screenings do I need?

Which screenings you need and when you need them depends on your age, gender and other risk factors. These factors can include lifestyle choices, such as whether you smoke, as well as your race, ethnicity and family history. Here are 2 examples:

• Everyone should get screened regularly for colorectal cancer between the ages of 45 and 75. However, if you have a family history of the disease, you may need to get screened earlier.
• If you’re between the ages of 50 and 80 and you smoke now or you quit within the last 15 years and you have a history of heavy smoking, you may need to have an annual lung cancer screening. Nonsmokers can usually skip this screening.

“The best guide for knowing when to do screening tests is your primary care doctor,” Dr. Havert says. “Think of us like your ‘project manager’ for living a healthy life.”

What preventive services are recommended for adults?

First, it’s a good idea to see your doctor on a regular basis. Many health plans cover regular checkups once a year. Check your plan documents to see what it covers, or call a licensed insurance agent at 1-844-211-7730. You can also explore your benefit options online.

These checkups are a chance for your primary care doctor to go over your health history and address any concerns you have. They’ll track your height and weight and other vital signs such as blood pressure. Your doctor may do a physical exam where they look at and touch parts of your body to check for any problems. They’ll also ask you questions about things such as:

• Your eating and exercise habits
• If you smoke, drink or take other drugs
• Your mood and general well-being
• Your sexual activity

They’ll also see if you are due for any routine screenings or vaccinations. If so, they may do the screening during the visit, or help you set up an appointment to get it done at another time. Some screenings may need to be done at a special testing center.

These are some of the routine screenings that are typically covered by health plans:

Blood pressure

High blood pressure increases your risk of heart disease, stroke and other health problems. But high blood pressure typically has no symptoms, so it’s important to get it checked regularly.

What to expect: Your doctor will wrap a cuff around your upper arm that will fill with air to measure the pressure the blood exerts as it moves through your blood vessels as your heart beats. You can also check your blood pressure on your own. Many pharmacies have blood pressure machines on site that you can use, or you can purchase a home blood pressure monitor.

When to get it: Young adults (18 to 39 years old) should check their blood pressure every 3 to 5 years. If you’re 40 or older, or at higher risk of high blood pressure, you’ll want to check it once a year or more. Your doctor can give you more guidance on how often to get your blood pressure checked.

Cholesterol

High cholesterol can increase your risk of heart disease. The only way to know if your cholesterol is high is to get screened.

What to expect: Your doctor or a nurse will draw some of your blood and send it to a lab to measure:

• LDL (low-density lipoprotein) cholesterol
• HDL (high-density lipoprotein) cholesterol
• Triglycerides
• Total cholesterol

This is sometimes called a “lipid panel.” You may need to fast for 9 to 12 hours before getting your blood drawn; ask your provider if you’ll need to do this.

When to get it: In general, adults should get their cholesterol checked every 4 to 6 years. You may need to get checked more often depending on your risk of heart disease. Check with your health plan to see if a lipid panel will be covered for you. And talk to your doctor about how often you need to get screened.

Type 2 diabetes

Diabetes is a condition that causes high blood sugar, which can lead to heart disease, nerve damage, kidney disease and more. Screening can help catch the disease before you have symptoms. It can also detect “prediabetes” — high blood sugar that is above normal but not high enough to be considered diabetes. Prediabetes can be managed or reversed so that it does not progress to type 2 diabetes, which has no cure.

What to expect: Your doctor will draw some of your blood and send it to a lab to measure your blood sugar and/or your A1c. A1c is an indicator of your average blood sugar level over the past few months. You may need to fast for at least 8 hours before getting your blood drawn; ask your provider if you’ll need to do this.

When to get it: Everyone age 35 and older should be screened for diabetes every 3 years. Your doctor may recommend screening earlier if you have certain risk factors. And you may need to be screened more often based on the results of your previous test.

Colorectal cancer

Colorectal cancer is a cancer that develops in your large intestine, specifically in the colon or rectum. It usually starts as small growths on the lining of your large intestine. These growths can be detected and treated with screening tests.

What to expect: You can be screened for colorectal cancer with screening tests such as a colonoscopy or a stool test. During a colonoscopy, a doctor will insert a small tube with a camera on the end into your rectum and look at the inside of your large intestine. They can also remove any growths, called polyps, during this procedure, which can prevent colon cancer from forming.

Stool tests are less invasive. You’ll simply collect a sample of stool that will be sent to a lab for testing. They look for small amounts of blood and/or DNA in your stool that might indicate cancer. If your results are abnormal, your doctor will likely follow up with a colonoscopy to look for cancer.

Your doctor will help you decide which screening test is best for you.

When to do it: Experts recommend getting screened for colon cancer starting at age 45. Your doctor may recommend screening earlier if you have a family history of the disease or other risk factors. How often to get screened depends on the type of test you get and the results. If your results are normal, you’ll only need a colonoscopy every 10 years. Stool sample tests are done more often — usually every 1 to 3 years.

Lung cancer

A lung cancer screening is recommended only for current smokers or former heavy smokers, since they have a much higher risk of developing lung cancer.

What to expect: The recommended screening test for lung cancer is a low-dose computed tomography (LDCT) test. You’ll lay on a table (clothed) for a few minutes while an X-ray machine makes detailed images of your lungs using a low-dose of radiation.

When to do it: Talk to your doctor about getting screened for lung cancer if you are a smoker (or quit less than 15 years ago) and are aged 50 to 80. The test is also recommended for people that have a history of smoking 1 pack of cigarettes a day for at least 20 years or 2 packs a day for 10 years.

Sexually transmitted infections (STIs)

If you’re sexually active, your doctor may ask about your sexual behavior. They can provide counseling on safe sex practices. They may also recommend screening for certain diseases that can be passed through sex, such as HIV, gonorrhea and chlamydia.

What to expect: STI tests usually require a sample of blood, saliva (spit) or urine. You can get tested at your doctor’s office. Tests are also available at hospitals, community clinics and other testing sites. There are even tests you can take at home.

When to do it: Everyone ages 15 to 65 should get tested for HIV at least once. People at higher risk should get tested more often. For example, if you are a man who has sex with other men, you may need to get tested at least once a year.

Talk to your doctor about whether you should be screened for STIs, and which tests you should get.

What preventive services are recommended for women?

In addition to the screenings listed above, there are certain screenings that are recommended only for women or people assigned female at birth.

Breast cancer

Women have about a 1 in 8 chance of being diagnosed with breast cancer in their life. Screening can help catch breast cancer early when it is easier to treat and recover from.

What to expect: A mammogram is the best way to screen for breast cancer. It involves a technician taking X-ray images of your bare breasts while they are pressed between 2 plastic plates. A radiologist then looks at the images for signs of cancer.

When to do it: Around age 40, it’s a good idea to start talking to your doctor about your risk of breast cancer. All women should get a mammogram every 2 years starting at age 50. But your doctor may recommend getting a mammogram sooner if you have a family history of breast cancer or other risk factors.

Cervical cancer

Cervical cancer is less common than breast cancer but can be deadlier. Simple screening tests can help detect signs of cervical cancer early, sometimes before it has even progressed to cancer.

What to expect: Your doctor will take a sample of cells from your cervix, which is the narrow end of the uterus that connects the uterus to the vagina. The sample will be sent to a lab for a Pap test or HPV (human papillomavirus) test (or both). A Pap test checks for abnormal cells that could be an early sign of cancer. An HPV test checks for infection with a virus that can cause cervical cancer.

When to do it: If you are 21 to 29 years old, you’ll want to get a Pap test every 3 years. If you are 30 to 65 years old, you can continue getting a Pap test every 3 years, get an HPV test every 5 years, or you can get an HPV or HPV/Pap combo test every 5 years. If you are over 65, ask your doctor if you should continue being screened.

Your doctor can help you decide which test is right for you. You may need to be screened more often if you have an abnormal result on a test.

Bone density

Postmenopausal women are at a higher risk of osteoporosis, a condition of weakened bones. Osteoporosis can increase your risk of bone fractures, especially in the hips, spine and wrists.

What to expect: Your bone density can be measured with a DEXA (dual X-ray absorptiometry) scan. This is a special type of X-ray that can look at the density of your bones. During the procedure, you’ll lie on a table (clothed) while an X-ray image is taken.

When to do it: If you’re 65 or older, talk to your doctor about scheduling a DEXA scan. Medicare typically covers a bone density scan every 2 years if you meet certain conditions. If you’re under 65, but have gone through menopause, ask your doctor if you need a DEXA scan earlier.

What preventive services are recommended for men?

Men or people assigned male at birth don’t have an extensive list of gender-specific preventive screenings like women or people assigned female at birth do.

One that often comes up is screening for prostate cancer, which is more common in older men, African American men and men with a family history of the disease.

Experts don’t recommend prostate screenings for all men, in part because the cancer is very slow growing and because treatment can cause loss of bladder control and erectile dysfunction. Talk to your doctor about whether a prostate cancer screening is right for you.

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What other preventive screenings are important?

The screenings discussed above can be ordered by your doctor and are typically covered by your health insurance plan. But there are 2 other important checkups to get at least once each year:

1. A dental exam
2. An eye exam

These exams are not covered by major medical insurance. You’ll have to pay out of pocket for this care. Or you can enroll in supplemental dental and vision insurance plans (you can also bundle these plans). These plans typically have relatively low monthly bills (premiums) but can help you save money on important dental and vision care.

You can shop for dental and vision insurance by calling a licensed insurance agent at 1-844-211-7730. You can also start by learning more about combined insurance plans (if available in your area).

Disclaimer

For informational purposes only. This information is compiled by UnitedHealthcare and does not diagnose problems or recommend specific treatment. Services and medical technologies referenced herein may not be covered under your plan. Please consult directly with your primary care physician if you need medical advice.

Sources

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Medicare.gov. “Preventive & screening services.” Retrieved from https://www.medicare.gov/coverage/preventive-screening-services Accessed May 24, 2023.

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My Health Finder. “Prostate Cancer Screening: Questions for the Doctor.” March 24, 2021. Retrieved from https://health.gov/myhealthfinder/health-conditions/cancer/prostate-cancer-screening-questions-doctor

National Cancer Institute. “Cervical Cancer Screening.” April 27, 2023. Retrieved from https://www.cancer.gov/types/cervical/screening

National Cancer Institute. “Screening Tests to Detect Colorectal Cancer and Polyps.” August 2, 2021. Retrieved from https://www.cancer.gov/types/colorectal/screening-fact-sheet

National Institute of Diabetes and Digestive and Kidney Diseases. “Diabetes Tests & Diagnosis.”

July 2022. Retrieved from https://www.niddk.nih.gov/health-information/diabetes/overview/tests-diagnosis

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