What Is Preventive Care?
Preventive care includes health services that help detect or prevent serious diseases and medical problems before they become major. Under the ACA, most health insurance plans must cover certain preventive services without charging you a copay, coinsurance, or requiring you to meet your deductible first.
Key Preventive Services for Adults
- Annual wellness visit / physical exam
- Blood pressure screening
- Cholesterol screening
- Type 2 diabetes screening
- Colorectal cancer screening (age 45+)
- Depression screening
- Immunizations (flu, Tdap, COVID-19, shingles, etc.)
- HIV screening
- Obesity screening and counseling
- Tobacco use screening and cessation support
Preventive Services for Women
Women have access to additional no-cost preventive services including mammograms, cervical cancer screening (Pap smear), contraception, prenatal care, and BRCA genetic testing for those at higher risk.
Preventive Services for Children
Children's preventive benefits include well-child visits, developmental screenings, vision screening, dental care (fluoride and sealants), hearing screening, and all recommended vaccinations.
Important Fine Print
Preventive services are only free when provided by an in-network provider. If a preventive visit leads to additional diagnostic services (like a biopsy after a screening), those follow-up services may be subject to your normal cost-sharing. Always ask your provider what will be billed as preventive vs. diagnostic.
