Preventive care

Preventive care is routine care meant to keep you healthy or find problems early. It includes screenings, checkups, shots, and some counseling. Most plans must cover certain preventive services without a copay or coinsurance, even before you meet your deductible. The care usually has to come from an in-network provider.

Billing problems can start when part of a visit is coded as diagnostic instead of preventive. That can happen if you bring up a new health problem and the provider treats it. Then your deductible or coinsurance may apply to that part.

For example, say your yearly checkup is billed as preventive care, so you owe $0 for it. During the visit, the doctor also checks a painful knee. That exam may be billed as a separate $120 office visit that goes toward your deductible. If you get a bill for care you expected to be free, ask the provider how the visit was coded. Our guide to a screening colonoscopy bill walks through a common case.