A red and white logo for planstin administration

Your right to understand the difference between preventive and diagnostic care.

April 10, 2024

Group health plans managed by Planstin offer preventive care coverage as outlined by the ACA. Some plans may require that these preventive services be performed in-network for coverage. Not all plans cover diagnostic exams. 

Note: Please see your plan’s Statement of Benefits and Coverage (SBC) or call us at 888-920-7526 for specific details about your plan.


What is a preventive health screening?

A preventive health screening, such as a colonoscopy or mammogram, is performed as a part of your routine health care. Your doctor may order one once you reach a certain age to ensure there are no unseen health changes.


What is a diagnostic health exam?

A diagnostic health exam, such as a diagnostic colonoscopy or mammogram, is performed when you or your doctor are concerned about changes in your health. Your doctor will order a diagnostic exam to try and find the cause of your symptoms and to make a medical diagnosis.

Learn More

  • To learn more about preventive and diagnostic care, click here. 


  • View all ACA outlined preventive services here.


  • Red more about the ACA's expansion of the Patient's Bill of Rights here.


  • Questions about your coverage? Contact a Benefit Advocate at 888-920-7526.




SUGGESTED READING

January 29, 2025
Most Planstin-managed health plans do not use a provider network . That means you are free to work with any provider with out fear of any out-of-network penalties. Very few Planstin-managed health plans still use a provider network. In this case, your health plan uses the PHCS network of providers. Fair-priced healthcare & care coordination The majority of Planstin-managed health plans use an innovative healthcare pricing strategy called fair-priced healthcare. This strategy does not require the use of a provider network, and instead relies on a care coordination team to help you work with your provider, make appointments, and locate providers that work well with your benefits. To learn more about fair-priced healthcare, click here . To learn more about care coordination click here .
January 29, 2025
Preventive Core is a health plan that focuses on preventive care. This health plan meets ACA requirements for minimum essential coverage (otherwise known as MEC). Fair-priced healthcare This health plan uses an innovative healthcare pricing strategy called fair-priced healthcare. To learn more about fair-priced healthcare, click here . Care coordination Preventive Core health plans have no network restrictions and include care coordination services to help you make appointments and locate providers that work well with your benefits. To learn more about care coordination click here . To view information about your Preventive Core health plan, click here and select your specific plan name.
Planstin Help Center logo.
January 24, 2025
All Planstin-managed health plans now feature care coordination services as a part of a fair-price healthcare strategy. The Planstin Care Coordination team will help match members with providers that work best with their plan.
Show More
Share by: