When you receive preventive care, you won't have a copay. During that visit, if you also receive care that's not considered preventive care, then a copay will be charged.
For example: If you go to your doctor for a seasonal flu shot and an annual wellness visit, you wouldn't have a copay because these are preventive care services. If during the same visit, you tell your doctor about a condition that requires an X-ray or you ask to have a skin tag removed, you would have a copay for those two services. That's because the X-ray is used to diagnose and the skin tag removal is a separate procedure, neither of which are considered preventive care.
It's helpful to know what types of care are considered preventive.
Preventive care includes:
- An annual wellness visit that is a comprehensive, preventive medicine evaluation that results in a prevention plan based on your needs
- Services to help you avoid illness or injury, including flu shots or pneumonia vaccines
- Tests and screenings to detect undiagnosed diseases or problems, including routine cancer screenings, such as mammograms
Preventive care does not include:
- Diagnosis or monitoring of a problem or symptom you already have
- Treatment of pain or other symptoms of an illness or disease
- Treatment of problems found during a preventive care appointment