Free preventive care: what's covered and how to avoid a surprise bill

The basic rule

Under the Affordable Care Act (ACA), most health plans must cover a set of preventive services, like shots and screenings, at no cost to you. That means no copay, no coinsurance and no deductible for those services, as long as you see a provider in your plan's network.

KFF estimates that about 100 million people with private coverage use these no-cost preventive services each year. But "free" has limits, and knowing them can save you money.

Where the list of free services comes from

The ACA does not list every service itself. Instead, it ties free coverage to recommendations from three expert sources:

• The U.S. Preventive Services Task Force (USPSTF): services it grades "A" or "B," such as certain cancer screenings and blood pressure checks.
• The Advisory Committee on Immunization Practices (ACIP): vaccines it recommends, once adopted by the CDC.
• The Health Resources and Services Administration (HRSA): guidelines for women's preventive care and for children's care under the Bright Futures program.

Common examples

According to HHS, services that are often covered at no cost include:

• Blood pressure, diabetes and cholesterol screenings.
• Cancer screenings, such as mammograms and colonoscopies.
• Counseling on quitting smoking, losing weight, eating well, depression and alcohol use.
• Routine vaccines for children and adults, including flu shots.
• Well-baby and well-child visits.
• Counseling, screenings and vaccines for a healthy pregnancy.

What the Supreme Court decided

On June 27, 2025, the Supreme Court ruled 6 to 3 in Kennedy v. Braidwood Management. A group of employers had argued that the Task Force's members were appointed in a way that violated the Constitution. The Court disagreed and upheld the ACA's requirement to cover recommended preventive services at no cost.

The ruling also confirmed that the Health Secretary can remove Task Force members at will and can review the recommendations they issue. KFF and other analysts noted this gives the Secretary more influence over what ends up on the free list.

What has happened since

The Task Force has not met in more than a year. In 2026, Health Secretary Robert F. Kennedy Jr. removed the panel's vice chairs, and on September 17, 2026, he named eight new members and a new chair. As of late October 2026, we found no reports that the Task Force had changed its existing A and B recommendations, so plans must still cover those services at no cost in network. No date for its next meeting had been announced.

Vaccine coverage has its own uncertainty. A federal court case has kept ACIP from voting since early 2026. The insurer trade group AHIP has said its member plans will keep covering ACIP-recommended vaccines with no cost-sharing through the end of 2027. Rules could change, so check with your plan before you go.

When free care isn't free

Some plans are exceptions. If your plan is "grandfathered," meaning it existed before the ACA and hasn't changed much since, these no-cost benefits may not apply. Your plan documents will say if it is grandfathered.

Even in a regular plan, a preventive visit can create a bill. HHS notes that services are free only from in-network providers, and your plan may charge an office visit fee if prevention isn't the main purpose of the visit. If you bring up a new problem, like knee pain, or ask the doctor to manage a condition you already have, that part of the visit may be billed as diagnostic care, with your usual copay or deductible.

Tests can shift, too. A screening done because you have symptoms, or done more often than recommended, may be treated as diagnostic. KFF Health News has reported on patients billed after a polyp was removed during a screening colonoscopy, even though federal officials have said polyp removal is part of the screening.

What to say when you book

A few questions up front can prevent most surprises:

• Say clearly: "I'm scheduling a preventive visit" or "a screening."
• Ask whether the doctor, lab and any anesthesiologist are in your plan's network.
• Ask your plan whether the specific test is covered at no cost for someone your age and risk level.
• If you want to discuss a new problem, ask whether that will be billed separately, or book a second visit.
• Before a planned procedure, ask the provider and your plan for a cost estimate.
• If you get a bill for something you think was preventive, call your plan and ask for it to be reviewed.

If you have Medicare

Medicare has its own preventive benefits, separate from the ACA's private-plan rules. Medicare says you pay nothing for most preventive services if you get them from a provider who accepts assignment. Covered services include screening mammograms, colonoscopies, diabetes screenings, lung and prostate cancer screenings and flu shots, plus a "Welcome to Medicare" preventive visit and a yearly wellness visit. You can see which preventive services you're due for by logging in to your Medicare account.

This article is general information. Talk with your doctor about which screenings make sense for you, and call your plan to confirm coverage.