Video Transcript: Health Care Reform Demystified

In a richly decorated office, quick shots show U. Horace Cartwright as he pages through a book, waves a conductor's stick, stands in front of a chalkboard, balances scales, and talks on the phone. Rousing classical piano music plays.

ON SCREEN TEXT: Health Care Reform Demystified WITH U. HORACE CARTWRIGHT

U. HORACE CARTWRIGHT: Welcome to Health Care Reform Demystified. Today's episode: preventive care coverage under the Affordable Care Act.

In the office, U. Horace Cartwright hums as he hunches over his desk holding a set of brass balance scales. The weight to his right is larger than the weight to his left. He looks up and addresses the camera.

U. HORACE CARTWRIGHT: (humming) There's an old saying about preventive medicine, "an ounce of prevention is worth a pound of cure." This obviously doesn't work with actual weights...

He lets go of the weight dishes, and the heavier weight to his right falls.

U. HORACE CARTWRIGHT: But it's an accurate expression of value that holds true for health care today.

He moves the set of scales to the side and continues speaking to the camera.

U. HORACE CARTWRIGHT: Routine checkups and preventive services may help people avoid serious health problems and maintain their health. That's why the Affordable Care Act contains a provision to make certain important preventive services available without having to pay copays, co-insurance, or deductibles.

He holds up a sign.

ON SCREEN TEXT: Preventive Services

U. HORACE CARTWRIGHT: Some examples of preventive services covered by this provision include...

He holds up a sign showing alphabet blocks.

U. HORACE CARTWRIGHT: Well baby and well child care...

He holds up a sign of someone self-checking blood pressure with an upper-arm cuff.

U. HORACE CARTWRIGHT: Blood pressure, diabetes, and cholesterol screening...

He holds up a sign of a glass tumbler and a lit cigarette in an ashtray.

U. HORACE CARTWRIGHT: Screenings for health issues such as smoking, depression, and alcohol abuse...

He holds up a sign of a needle and syringe.

U. HORACE CARTWRIGHT: Routine vaccinations and immunizations...

He holds up a sign of an ear.

U. HORACE CARTWRIGHT: And even hearing screenings. The provision also covers screening mammograms and screening colonoscopies.

He holds up his hand.

U. HORACE CARTWRIGHT: Sorry, no visual aids for those.

Now, he stands in front of a bookcase that holds a marble bust while classical piano music plays. He holds a conductor's stick and waves it in time with the music.

U. HORACE CARTWRIGHT: One important thing to note is that a procedure can be considered preventive care in some situations, but not in others. This is important because a service has to be considered preventive in order to be exempt from copays, co-insurance, or deductibles. If it's not, these charges may apply. To help make sense of this, let's play a quick round of Preventive or Not Preventive. I'll describe a situation and you tell me whether or not it's an example of preventive care. Yes, I know, I can't actually hear you, but just play along.

Now, he stands in front of a chalkboard while smooth music plays.

ON SCREEN TEXT: Preventive

 Not Preventive

U. HORACE CARTWRIGHT: Here's the first situation: a woman visits a doctor in her network for an annual mammogram. Preventive, or not preventive?

A buzzer blares.

U. HORACE CARTWRIGHT: The correct answer is preventive, because her visit is part of a routine annual exam and not because she had a previous diagnosis. Seems simple enough, right? Okay, how about this? A woman visits a doctor in her network for an annual mammogram, but the results prompt the doctor to ask her to come back in six months for a follow up visit and a follow up mammogram.

A buzzer blares.

U. HORACE CARTWRIGHT: In this case, the first mammogram is considered preventive, but the second is not. The second mammogram, which is done much sooner than a screening mammogram and any additional tests would be considered treatment for a diagnosed condition. Let's try another one. A man receives a blood test to measure his cholesterol level at his annual wellness exam.

A buzzer blares.

U. HORACE CARTWRIGHT: In this case, the office visit and the blood test are considered preventive care because the patient who was being screened has no known symptoms, illness, or injury. With me so far? Let's do one more. A man makes quarterly visits to his doctor for blood tests to check his cholesterol level and to confirm the medication dosage is appropriate.

A buzzer blares.

U. HORACE CARTWRIGHT: Because they are part of a treatment regimen for an existing condition, the quarterly blood tests are not preventive care. So let's review the basics and cover a few more considerations on preventive care.

A graphic of a chalkboard appears while light music plays. U. Horace Cartwright reads the writing on the board.

ON SCREEN TEXT: Preventive care coverage The Affordable Care Act makes certain preventive services available to most plan members without copays, coinsurance or deductibles.

U. HORACE CARTWRIGHT: The Affordable Care Act makes certain preventive services available to most plan members without copays, co-insurance, or deductibles.

The chalkboard flips over, and a piece of chalk begins writing.

ON SCREEN TEXT: To be covered without member cost-sharing, the tests, examinations, and other medical services must be preventive.

U. HORACE CARTWRIGHT: To be covered without member cost-sharing, the tests, examinations, and other medical services must be preventive and not part of a diagnostic procedure or ongoing treatment for an existing condition.

The chalkboard flips over, and the chalk starts writing.

ON SCREEN TEXT: If a plan includes a network of providers, the elimination of copays, coinsurance, and deductibles for certain preventive services applies only to in-network providers.

U. HORACE CARTWRIGHT: If a plan includes a network of providers, the elimination of copays, co-insurance, and deductibles for certain preventive services applies only to in-network providers. In fact, some plans may not cover preventive services that are received out of network at all.

The chalkboard flips over, and the chalk starts writing.

ON SCREEN TEXT: Vitamins, nutritional supplements, aspirin, over-the-counter medications, fitness classes, and health club memberships are not considered preventive care services.

U. HORACE CARTWRIGHT: Vitamins, nutritional supplements, aspirin, over-the-counter medications, fitness classes, and health club memberships are not considered preventive care services. These services are not covered at all.

The chalkboard flips over, and the chalk starts writing.

ON SCREEN TEXT: Some grandfathered health plans are exempt from the preventive services provision.

U. HORACE CARTWRIGHT: Some grandfathered health plans are exempt from this provision.

Now, he sits at his desk and addresses the camera while light music plays. He holds up a bowl of apples.

U. HORACE CARTWRIGHT: Well, it's long been said that one of these a day keeps the doctor away. Taking advantage of routine preventive care services is a much better bet for long-term health and wellness.

The scene fades to black, and the UnitedHealthcare logo and text details appear.

U. HORACE CARTWRIGHT: You can dig deeper into the details of what the Affordable Care Act has to say about preventive care services and other important topics on the United For Reform website.

ON SCREEN TEXT: UnitedHealthcare® uhc.com/reform

U. HORACE CARTWRIGHT: And, as always, contact your broker or UnitedHealthcare representative with any questions about your health plan.

The text fades, and light jazzy music plays. In an inset video on a black background, U. Horace Cartwright eats an apple. The video is sepia-toned and grainy like old footage.

U. HORACE CARTWRIGHT: Mmm. Oh. My heavens, that's delicious. I feel better already.