Many preventive care services are covered at 100% – meaning your plan covers them at no extra cost to you. To be covered, the service must be at an in-network doctor or facility, filed by your doctor as preventive care, and identified as preventive care under the Affordable Care Act (ACA). See your coverage by logging into your personalized member portal.
Under the Affordable Care Act, some medications are covered at 100% on all prescription drug lists or formularies.
These medications include aspirin, certain supplements, tobacco cessation support and some contraceptives.
Sometimes you go to the doctor for preventive care and end up with a charge on your bill. You can avoid surprising costs by following these steps:
Preventive services are services you get when you are symptom-free and have no reason to think you are sick. These services may include immunizations, routine cholesterol checks, pap tests and blood pressure screenings. They are covered at no extra cost.
Diagnostic services, on the other hand, are services you get when you have symptoms of an illness or risk factors that might indicate a health problem. These services may include chest X-rays, thyroid tests, EKGs, urine tests and iron level testing. You may be responsible for some out-of-pocket costs.
The Affordable Care Act (ACA) has identified certain services as preventive care services paid at 100%. This information is a reference tool and does not guarantee payment of any claims.
Blue Cross and Blue Shield of North Carolina does not discriminate on the basis of race, color, national origin, sex, age or disability in its health programs and activities. Learn more about our non-discrimination policy and no-cost services available to you.
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