Preventive Care

Most plans must over a set of preventive services – like shots and screenings – at no cost to you.

For example, depending on your age, you may have access to no-cost preventive services such as:

• Blood pressure, diabetes, and cholesterol tests
• Many cancer screenings, including mammograms and colonoscopies
• Counseling on such topics as quitting smoking, losing weight, eating healthfully, treating depression, and reducing alcohol use
• Regular well-baby and well-child visits
• Routine vaccinations against diseases such as measles, polio, or meningitis
• Counseling, screening, and vaccines to ensure healthy pregnancies
• Flu shots and other vaccines

Why am I being charged a fee for preventive care?

Your health plan may charge a fee if:

• Out-of-network providers: These services are free only when delivered by a doctor or other provider in your plan’s network. Your health plan may allow you to receive these services from an out-of-network provider but may charge you a fee.

• Office visit fees: Be aware that your plan can require you to pay some costs of the office visit if the preventive service is not the primary purpose of the visit.
• Grandfathered plans: If your plan is “grandfathered,” these benefits may not be available to you.

Questions

• Talk to a health care provider to know which covered preventive services are right for you — based on your age, gender, and health status. 
• Contact your insurance company if you have questions about your plan or fees.