Preventive care
Updated for plan year 2026
In plain terms
Preventive care is the set of recommended screenings, vaccines, and counseling that marketplace plans must cover at no cost when you use an in-network provider, even before you meet your deductible. It includes things like annual wellness visits, blood-pressure and many cancer screenings, routine immunizations, and well-child and well-baby care. The point is to catch problems early, so the law removes the cost barrier. The free pricing applies to the recommended preventive service itself, given in network.
A plain example
You go in for a covered annual physical and a recommended cholesterol screening. Even though you're nowhere near meeting your $4,000 deductible, you pay $0 because both are in-network preventive services. But if the same visit turns into treatment for a new complaint, that added care can run through your normal deductible and copays.
Why it matters
Preventive care is the part of your plan that pays off whether or not you get sick, because it's free in network from day one. Using it is a way to get value from coverage you're already paying premiums for, and to catch issues before they become expensive.
A common point of confusion
The no-cost rule has edges. It applies to the recommended preventive service from an in-network provider, so going out of network, or having the visit turn into treatment for a problem, can leave you charged your normal deductible, copay, or coinsurance.