“I can’t believe how much I will have to pay for health insurance when I barely use it. I only had one doctor visit last year!”

This was Margaret’s reaction when we walked her through her health plan options. She’s a new client, coming off an employer-sponsored plan that was heavily subsidized. Understandably, the cost of purchasing a new health insurance plan seemed staggering, especially when her utilization was so low.

But there is a silver lining for Margaret and many like her: Thanks to the Affordable Care Act, she has access to several plans offering excellent, comprehensive health coverage. Within that coverage (and associated cost) is preventive care, a valuable but generally underappreciated health insurance component that many people overlook.

Margaret’s monthly premium wasn’t just buying peace of mind for future illness. By tapping into the value of prevention, it was an investment in her long-term health and financial well-being.

High Value at No Additional Cost

We don’t yet know what premium rates will be in 2026, but one thing is certain: they will rise. But whatever the final numbers, it’s important to recognize that those premium dollars provide access to thousands of dollars in essential services — preventive care at no additional cost! 

That’s because preventive services are completelycovered under the Affordable Care Act’s requirements for private insurance and under Social Security law for Medicare. Think of it as money you’ve already spent sitting in a health account with your name on it. 

Your insurance plan likely covers an extensive array of preventive services. Here are just a few examples of the preventive care you have access to:

• Annual wellness visits
• Mammograms
• Colonoscopies
• Heart disease risk assessments
• Blood glucose testing
• Bone density scans
• Immunizations such as flu, COVID-19, Shingles, Pneumonia, Tdap

To make this even more attractive, they have removed the typical barriers you might expect: no deductibles, no co-pays, no referrals needed for screenings.

Plus, the hidden goldmine isn’t just financial. It is the benefit that comes from catching problems early when they’re most treatable and least expensive to address. That’s why your insurance provider wants you to use preventive care: keeping you healthy costs the plan far less than treating advanced diseases. 

Preventive Dental Care: Another Smart Health Strategy 

Preventive dental care (cleanings, exams, X-rays) also plays a crucial role by lowering the risk of systemic diseases such as cardiovascular disease, diabetes, respiratory infections, and chronic inflammation. By committing to regular, professional dental maintenance, you are not only safeguarding a healthy smile but also protecting your overall physical health. 

Here at Healthassist, we recently analyzed real-world data on dental insurance and uncovered a compelling financial upside: plans that focus exclusively on preventive care yield a net positive financial return for plan participants. 

That means you’re not just covered for your regular cleanings, you are financially ahead when you invest in a preventive care dental plan. The only catch: You must make and keep those routine maintenance appointments to reap the benefits. 

Community Benefits

Preventive vaccinations don’t just protect you — they protect your family, friends, and community by reducing the spread of communicable diseases. 

Considering that several of our older adult clients passed during the first few months of COVID, we have no better reminder than how transformative and effective the COVID-19 vaccine was to our local communities and to overall global health. When we stay current with recommended immunizations, we contribute to the health and safety of everyone around us.

Live Better Longer

Preventive care isn’t just about avoiding disease — it’s about preserving your quality of life. Regular wellness visits and screenings can help you stay independent as you age, mitigate the physical and emotional toll of advanced illness, and keep your healthcare costs manageable over your lifetime.

When we identify a condition like high blood pressure or diabetes early, we can often manage it with lifestyle changes and minimal medication. But if we wait until symptoms appear, we’re looking at more intensive treatments, complications, and higher costs. 

The difference between prevention and reaction can mean the difference between taking one medication versus five, between annual check-ups versus monthly specialist visits, and even the difference between independence and assisted care.

Take Action Today

Specifically…

• At your next visit, ask your doctor which preventive screenings they recommend based on your age, health history, and risk factors. Don’t leave the office without understanding what conditions you might be at risk for and how to best screen for them.

• Review your insurance benefits by logging into your private insurance portal. Look for your “Summary of Benefits” or “Evidence of Coverage” documents to understand exactly what preventive services are available to you and how often you can receive them. You may be surprised at the services you are eligible for that you didn’t know were covered.

• If you have Medicare, visit the Medicare.gov website for a complete list of covered preventive services and details for coverage.

• When scheduling preventive care, ensure the appointment and any screening tests are specifically designated as preventive services. Verify that your physician’s orders clearly state the tests are for screening purposes and discuss with your doctor whether you meet your plan’s specific guidelines for age, frequency, and risk factors to qualify for preventive coverage.

• Make sure your doctor and the testing facility for all screening tests accept your insurance plan as an in-network provider. Using an out-of-network provider will result in out-of-pocket costs or might not be covered.

• Schedule preventive appointments well in advance and establish an annual routine. Use technology to your advantage — set up calendar reminders for screenings and utilize your physician’s portal for appointment scheduling.

No Excuses: Preventive Care is Easy and Essential

Even if you feel perfectly healthy, preventive care remains essential. High blood pressure, diabetes, and many cancers develop silently. By the time symptoms appear, you’ve missed the window for the most effective, least expensive interventions. Skip the screening, and you might face decades of disease management costs.

Your insurance has already paid for these services for you. The only question is whether you’ll claim what you’re entitled to receive.