ACA Health Plans Cover Cancer Screenings
During a recent dental visit, a dentist recommended a mouth/gum cancer screening. The patient does not have dental insurance but has a Gold ACA policy. He or she wants to know if a primary care doctor can perform the screening so it will be covered.
The answer is yes. Cancer screenings are covered as preventive services by all health insurance plans that comply with the Affordable Care Act (ACA). This includes mouth/gum cancer screenings.
What is a preventive service?
A preventive service is a healthcare service that is intended to prevent or detect a disease or condition before it becomes a major problem. Cancer screenings are preventive services because they can help detect cancer early, when it is most treatable.
How often should I get a mouth/gum cancer screening?
The American Dental Association recommends that adults get a mouth/gum cancer screening every three years. The screening involves a visual examination of the mouth and gums, as well as a palpation (feeling) of the lymph nodes in the neck.
Who can perform a mouth/gum cancer screening?
A dentist or a primary care doctor can perform a mouth/gum cancer screening.
How much does a mouth/gum cancer screening cost?
The cost of a mouth/gum cancer screening varies depending on the provider and the location. However, it is typically covered as a preventive service by health insurance plans that comply with the ACA.
What if I have a positive mouth/gum cancer screening?
If a mouth/gum cancer screening is positive, it does not necessarily mean that you have cancer. However, it does mean that you need to see a specialist for further evaluation.
How can I find a primary care doctor who can perform a mouth/gum cancer screening?
You can find a primary care doctor who can perform a mouth/gum cancer screening by using the HealthCare.gov website or by calling the National Cancer Institute’s Cancer Information Service at 1-800-422-6237.
You can also get help finding a licensed agent in your state by calling 1-800-318-2596 (TTY: 1-855-889-4325).
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