There is No Cost to You for Preventive Care

So, Make Sure You Don’t Get Billed for It!

It’s up to you to make sure your provider knows you are scheduling preventive care—and that you don’t get charged for it. Your Health Plan pays 100% (no deductible or coinsurance required) for an annual wellness visit and preventive services recommended by the U.S. Preventive Services Task Force (USPSTF A and B recommendations).

When you schedule an appointment for preventive care, follow these tips to help make sure you don’t get billed for regular care.

DO SAY: “I’d like to schedule an annual wellness exam.”

  • Schedule an annual wellness exam for an overall health checkup and to schedule preventive services. Did You Know? Preventive services can detect serious health conditions early, when they are most treatable.

DON’T SAY: “I need to make an appointment to update my prescriptions.”

  • Schedule an annual wellness exam during which you can review your ongoing prescriptions. Did You Know? This is also the time to talk about general wellness concerns, such as weight management, mental health, or quitting smoking.

DON’T SAY: “I need the doctor to look at a mole” (or other specific issue).

  • Schedule an annual wellness exam, where you can ask about specific, non-urgent health concerns (like that mole). Did You Know? Your doctor may refer you to a specialist or schedule a separate office visit to diagnose or treat specific issues if needed, and you’ll pay the usual copay then.

DO SAY: “I want to schedule PREVENTIVE—not DIAGNOSTIC—services.”

  • Schedule follow-up preventive services (like mammograms and colonoscopies), making sure they won’t be billed as diagnostic care. Did You Know? Preventive screenings detect conditions; diagnostic tests are used on existing conditions.

DO SAY: “I think I was incorrectly billed for a preventive service.”

  • Call your provider first if you think you were charged for recommended preventive services. Ask them to correct it and resubmit the claim. Did You Know? Compare your bills to your Explanation of Benefits (EOBs) to make sure you are billed correctly.





back to top