What does preventive care cover?

What is preventive care?

Preventive care includes things such as regular check-ups, screenings and immunizations. It may be covered without cost-sharing when you visit a doctor that is in your health plan’s network. This type of care may also help you catch health problems before they become serious. Talk to your doctor about what care is right for you.*

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Why is it important to have a preventive visit?

Having a preventive visit allows your doctor to evaluate your health and make sure you get the right screenings for your age, gender and family history. This visit can help you stay healthy and may help you identify health concerns before they become a long term condition.

Preventive care recommendations (PDF)

What’s the difference between a preventive visit and an office visit?

Preventive visits, sometimes called a routine check-up, are different than an office visit scheduled to discuss a specific medical problem. You would see your doctor, nurse practitioner or physician’s assistant for a preventive visit when you feel healthy. It may include care like an exam, checking your blood pressure, or getting recommended vaccines. These visits may be covered without cost-sharing when you use an in-network provider (doctor, nurse practitioner, physician’s assistant).

Office visits generally include checking on symptoms to treat a specific medical condition or problem.

Why was I billed for my preventive visit?

What are some examples of preventive services?

Preventive care includes services such as immunizations and regular check-ups.

preventive care services details (PDF)

How often should I get a preventive visit?

How often you see your doctor depends on your age, gender, and medical and family history. For certain adults, preventive visits may be recommended as often as once a year. Everyone has different health care needs, so ask your doctor how often you should be seen. Be sure to check the details of your plan before you make an appointment with a doctor. Some Blue Cross plans may not cover preventive services or have varying levels of coverage. 

Things that may occur during a preventive visit include immunizations, blood pressure and cholesterol measurement, diabetes screening, or counseling on healthy weight.  Your doctor may also recommend other screenings.*

How will it be covered?

Many Blue Cross plans cover preventive care services without cost-sharing when you see a doctor that is in your health plan’s network. Be sure to check the details of your plan before you make an appointment with a doctor.

Sometimes, your doctor will order tests during your preventive care visit that are not considered preventive care. These tests may be subject to deductibles, copays and/or coinsurance. Your doctor may also treat an existing condition (or you may have symptoms of an illness at the time of your visit). Treatment or tests for that existing condition are not preventive care and are subject to deductibles, copays and/or coinsurance.

preventive care services details (PDF)

Where should I go for more information or if I have questions?

Call the customer service number on the back of your member ID card for information. If you need to find a doctor, use our Find a Doctor tool.

More about preventive care

Preventive care for women 
Preventive care for men
Preventive care for newborns and young kids
Preventive care for kids ages 6-12
Preventive care as you age
Annual physical exams and preventive visits