Wall Street Journal Examines Health Coverage for Preventive Care
The Wall Street Journal on Thursday examined discrepancies among patients, doctors and insurers in defining preventive health care services and how that affects reimbursement.
The issue "has become particularly important for high-deductible plans," many of which will pay for preventive care before a patient has hit the deductible -- "but different insurers sometimes have different views on what constitutes preventive care," according to the Journal. The issue can be further complicated by doctors, who often do not identify certain services as preventive care when billing insurers.
Andrew Baskin, senior medical director at Connecticut-based Aetna, attributes the problem to the lack of universality among insurers. He said, "There is no industrywide definition here, so each insurer has the ability really to define preventive services for themselves."
The Journal reports that patients can have a particularly difficult time determining what prescription drugs are covered by their insurers as preventive treatments (Rubenstein, Wall Street Journal, 8/18).