In March 2010, the Affordable Care Act was signed into law requiring that all Marketplace health insurance plans provide “essential health benefits”. A few of these include emergency services, prescription drug coverage, mental health care, pediatric services, hospitalization, and finally the one we’re focused on today—preventive care.

When you’re enrolled in a plan under the Affordable Care Act, you will have access to dozens of different services. Plus, any of them that are considered preventive care are completely free. This means, you will have access to certain screenings, shots, and vaccines, at no cost to you.

Since the ACA went into effect, 20 million people have enrolled in health coverage. Over 10 million Americans signed up for coverage during the 2018 Open Enrollment Period alone. However, a lot of people don’t know which services are free and are ultimately not taking advantage of them. We’re hoping to help spread the word! That way you can start utilizing these free services, along with anyone else who is enrolled in an ACA plan.

The goal behind preventive care is to help prevent illnesses and diseases before they begin. When you’re enrolled in an ACA health insurance plan, you can meet with your doctor to obtain routine health screenings. These screenings can help determine your current health status and detect early warning signs of more serious problems.

The more you know about your health, the better. That way you’ll be well equipped to manage and maintain your health, helping you avoid something serious down the road.

Every ACA health insurance plan offers dozens of free preventive care services. However, understanding when these services are free and at what point you’ll have to pay can become a little confusing. Here are a few best practices to help you avoid an unexpected medical bill.

Whenever you’re using your health insurance, make sure to check if you’re going to an in-network or out-of-network provider. Any provider within your network will accept your health insurance and has already agreed to a pre-approved cost for their services. On the other hand, providers outside of your network don’t have the same agreement with your insurance company. Therefore, if you receive a preventive care service out-of-network, you may be responsible for part or all of the cost.

Your plan offers all sorts of free preventive care services and you want to take advantage of them. Whenever you’re scheduling an appointment, it’s a good idea to ask if the care you will be receiving falls under the list of “free” preventive care services and if not, to let you know.

Once you’re at your appointment, you can also ask your doctor. Especially because s/he might recommend additional services that don’t fall under this list.

Finally, one of the best places to find out is directly with your insurance company. They will be able to tell you what services are free and which ones are not.

Mistakes happen so it’s a good rule of thumb to scan each of your medical bills to determine what exactly you’re being charged for. If it’s not clear, you can always call your insurance company to confirm.

It’s also important to know, quite a few services have multiple billing codes associated with them. If you’re being charged for a service that’s supposed to be free under your coverage, the billing department may have chosen a code that doesn’t correspond to preventive care. If this is the case, call and ask if they can update the code. If you receive another bill, you can file an appeal with your insurance company.

Preventive care helps you manage your health while you're symptom free and healthy. This can include routine physicals, check ups, screenings, plus more. Diagnostic care helps diagnose a health condition or disease.

For example, if a woman receives a routine mammogram, this would be considered preventive care. However, if she discovers a lump in her breast, and then receives a mammogram to check on the lump, this would be considered diagnostic care.