Preventive Health Exams versus Non-Preventive Exams

Under the Affordable Care Act (ACA), your health insurance plan covers certain preventive health care services at no cost to you when delivered by a provider in your plan’s network.

Most of Quartz’s plans provide preventive health care services at no copay, even if you have not met your deductible, as long as you go to a health care provider within your network.

If you go to the doctor to get a preventive health care service at no charge and you discuss a different health problem, you can expect a bill for that additional service. Only preventive health care exams and services are provided at no out-of-pocket cost.

For example, if you go to the doctor to get your annual physical health exam (a preventive health care exam) and you ask about some other problem, you may be subject to out-of-pocket charges (copay, coinsurance or deductible) for this added service.