The Difference Between Preventive, Diagnostic, and Therapeutic Care
There’s a lot of terminology to navigate when it comes to your health care. The services and procedures you’re prescribed will generally fall under one of three types of care, and it’s important to know the differences between them.
Preventive Care
Preventive services and procedures are used to prevent or detect illness at an early stage when treatment is likely to work best. This type of care includes routine checkups (like your annual physical and Annual Wellness Visit), immunizations, and screenings.
Some additional examples of preventive services covered by your plan (with a $0 in-network copay) include:
- Breast cancer screening (mammograms)
- Depression screening
- Diabetes screening
- Prostate cancer screening exams
Diagnostic Care
As the name implies, diagnostic care includes services and procedures that diagnose—or identify—issues to determine the right treatment.
Some examples of diagnostic services include:
- Lab tests, such as blood or urine tests
- Sleep studies
- Stress tests
- Radiology services, like ultrasounds, MRIs, and CT scans
- EKGs
Sometimes, a service could be preventive or diagnostic, depending on the context. For example, your provider may recommend a colonoscopy because of your age. That would be preventive care. But if you were having certain symptoms and your doctor recommended a colonoscopy, that would be diagnostic care.
Therapeutic Care
Therapeutic care refers to the treatment or management of an already-diagnosed condition or disease.
For example, an endoscopy—in which a provider uses a tiny camera called an endoscope to visually examine an organ in your body—could be used in the ongoing treatment of a gastrointestinal condition.
Just as a service could be preventive or diagnostic, a service could be diagnostic or therapeutic—depending on when and how it’s being used in your care.
What to do if you’re unsure
If your provider recommends a test or procedure, you can ask whether it’s considered preventive, diagnostic, or therapeutic. The distinction is important when it comes to how your health plan treats the service. For example, you may be responsible for a copay or cost share if you receive diagnostic or therapeutic services that address a medical condition during a preventive visit—such as during your annual physical or Annual Wellness Visit.