What do the new rules about preventive services in the health care reform legislation mean for you?

By: Molly Edmonds

What are the Costs and Benefits of the Preventive Care Rules?

Hearing screenings are one of the many new services that are to be provided with no out-of-pocket cost to the patient.
Hearing screenings are one of the many new services that are to be provided with no out-of-pocket cost to the patient.

The White House estimates that premiums may rise by 1.5 percent to account for the new preventive care rules, but out-of-pocket costs will be more manageable. For example, a 58-year-old woman receiving a mammogram, a colon cancer screening, a Pap test, a diabetes test, a cholesterol test and a flu shot might spend $300 in co- pays for these tests; if she's covered by the new rules, however, she won't pay a dime.

It's hoped that long-term costs will decrease when up-front investments are made in Americans' care. For example, obesity and related illnesses are one of the biggest drivers of health care costs. Counseling on exercise and a healthy diet, in conjunction with regular check-ins and screenings, could go a long way in averting some of those long-term costs. And of course, regular preventive care can save lives because patients can address controllable risk factors and gain the advantage of early detection and treatment. According to a study cited by the White House, administering just five preventive services -- colorectal and breast cancer screenings, flu vaccines, and counseling about smoking and regular aspirin use -- could prevent 100,000 deaths each year. There are benefits to employers as well -- since sick days represent a tremendous loss in productivity, healthier workers lead to a healthier bottom line.


By the end of the next year, the White House estimates that 31 million people in new employer plans and 10 million people in new individual plans will have access to these preventive care services without having to worry about co-pays or out-of -pocket costs. The number of people covered by new employer plans is expected to jump to 78 million by 2013 [source: White House].

The ultimate success of this program will depend on those people who have this type of coverage. While the Affordable Care Act has removed one of the major barriers to preventive care -- cost -- it's up to the individual to go to the doctor and heed the recommendations the doctor provides.

For more information about the Affordable Care Act, visit the government's Web site, If you'd like more HowStuffWorks articles about the legislation and how it affects you, please see the links below.

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  • Alonso-Zaldivar, Ricardo. "Some preventive care to have no out-of-pocket cost." Associated Press. July 14, 2010. (July 14, 2010) aWJIWcnfxX8EQ9Q5PleI9XogD9GUV2TG1
  • Clark, Anna. "The fight for free birth control continues." Salon. July 14, 2010. (July 14, 2010) control_coverage
  • Web site. U.S. Department of Health and Human Services. (July 14, 2010)
  • Pear, Robert. "Health Plans Must Provide Some Tests at No Cost." New York Times. July 14, 2010. (July 15, 2010) th.html?_r=1