Free Preventive Care Services

Under the ACA, non-grandfathered health plans must cover a defined set of preventive services at $0 cost-sharing — no copay, no deductible, no coinsurance — when delivered by an in-network provider. This is free money for your health that millions of people leave on the table every year.

What's free for adults

• Annual wellness visit — the yearly checkup itself.
• Key screenings: blood pressure, cholesterol, diabetes (Type 2), colorectal cancer (45+), lung cancer (high-risk), depression, HIV, hepatitis B/C (at-risk), abdominal aortic aneurysm (men 65-75 who smoked).
• Vaccines: flu, COVID, Tdap, shingles (50+), and others per CDC schedule.
• Women's preventive: mammograms, cervical cancer screening, contraception, breastfeeding support, well-woman visits, osteoporosis screening.

What's free for kids

Well-child visits, developmental screenings, autism screening, vision and hearing screening, immunizations per CDC schedule, and more — pediatric preventive is comprehensive. If your kids are on your plan, their preventive care is $0.

The catch: how to keep it free

• In-network only — out-of-network preventive isn't guaranteed $0.
• Coding matters — if the visit turns diagnostic (you discuss a specific problem), parts may be billed as diagnostic. Ask the office how it's coded if you get a surprise bill.
• Follow the guidelines — frequency and age rules come from USPSTF/CDC; a screening outside the recommended schedule may not be free.
• Grandfathered plans are exempt — most Marketplace plans are not grandfathered, so this applies to you.

Common preventive mistakes

• Skipping the annual visit — it's free; the ROI on catching things early is enormous.
• Not asking about coding — "I want this visit coded as preventive" is a reasonable question at check-in.
• Assuming out-of-network is free too — it isn't; stay in-network for preventive.
• Forgetting kids' preventive — well-child visits and immunizations are fully covered; use them.

Pro tip: schedule next year's preventive visits before you leave this year's — the practices with the best doctors book out months ahead.

The bottom line

Free preventive care is the best deal in American healthcare — $0 screenings, vaccines, and checkups that catch problems early. Use it every year; it's the closest thing to free money your plan offers.

Key takeaway

The annual wellness visit, age-appropriate screenings, and recommended vaccines — all $0 in-network on ACA plans. Schedule them, keep them in-network, and question any bill for what's supposed to be free. Prevention is the highest-ROI care there is.

Worth repeating: the free annual visit is also your relationship-builder with a PCP — the doctor who'll catch things early for years to come.

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