What Is Preventive Care — and Is It Free?

Preventive care is healthcare designed to prevent illness or catch problems early — before they become bigger and more expensive. Under the Affordable Care Act, most health plans are required to cover specific preventive services with no cost-sharing.

That Means: No Copay, No Deductible

When you receive a covered preventive service from an in-network provider, you shouldn't pay anything — even if you haven't met your deductible. This applies regardless of your plan type.

What's Typically Covered as Preventive

• Annual wellness exam / physical
• Recommended immunizations (flu, COVID, etc.)
• Blood pressure screening
• Cholesterol screening
• Colorectal cancer screening (colonoscopy, etc.)
• Mammograms
• Cervical cancer screening (Pap smear)
• Diabetes screening
• Depression screening
• Tobacco cessation counseling
• Well-child visits and developmental screenings

The Important Caveat: "Preventive" vs. "Diagnostic"

Here's where people get surprised bills. If you go in for a "preventive" visit and your doctor finds something to investigate further — or you mention a symptom — the visit can shift from preventive to diagnostic. Diagnostic visits have normal cost-sharing.

Example: You schedule a preventive colonoscopy. During the procedure, a polyp is removed. Depending on your plan, the removal may be billed as diagnostic and subject to your deductible.

Ask your doctor ahead of time: "Will this be billed as preventive or diagnostic?"