Your medical plan covers an annual preventive care visit at no cost to you when services are delivered by a doctor or other provider in your plan’s network. This is care you get to prevent illness or disease, and it typically includes a comprehensive medical evaluation. Here’s what to expect at that visit:

  • Conversation about your medical, social, and family history
  • Physical examination
  • Review of current medications
  • Immunizations, as necessary
  • Age/gender-appropriate screening tests that can help you stay healthy and catch problems before they become serious threats to your health (e.g., blood pressure, cholesterol, and others as determined by risk factors such as age, weight, and others)
  • You won’t be charged a copay or fee for the visit as long as your doctor is an in-network provider and the service is coded as preventive care

Preventive vs. Diagnostic Care

Preventive care is generally precautionary. Diagnostic care and tests are given when someone has symptoms of a health problem and the doctor wants to find out why.

For example, if your doctor recommends having a screening colonoscopy based on your age, that’s covered as preventive care at no cost to you. However, if your doctor recommends a colonoscopy to investigate symptoms you’re having, that’s diagnostic care, and you’ll pay your share of your medical plan’s cost for that.