{"id":"health-plan-free-preventive-care","name":"Health Plan Preventive Care Without Cost Sharing","provider":"Centers for Medicare & Medicaid Services","entitlement_type":"government-benefit","entitlement_type_label":"Government benefit","entitlement_type_context":{"definition":"A government-funded or administered benefit, service, coverage program, assistance program, or public access route.","domain":"public-benefits","archetype":"direct-program","agent_instruction":"Identify the administering jurisdiction and disclose income, household, age, disability, immigration, residence, renewal, fee, and capacity rules that apply."},"summary":"Most health plans, including Marketplace plans, must cover a defined set of preventive services without a copayment or coinsurance and before the deductible when the current coverage rules are met.","benefit":{"description":"No-cost-sharing access to listed preventive screenings, immunizations, counseling, and services for adults, women, and children through most health insurance plans.","estimated_value_usd":null},"discovery":{"focus":"public-service","has_estimated_dollar_value":false},"access":{"relationships":["Person enrolled in a health plan that covers the applicable preventive service without cost sharing"],"requirements":"The person must be enrolled in a plan subject to the preventive-service requirement and meet the service's age, sex, pregnancy, risk, timing, and other criteria. The service generally must be received from an in-network provider, and coverage can vary.","activation":"Check the official preventive-service list and the plan's current coverage, confirm that the provider is in network and the visit will be billed as preventive, then schedule the service.","cost_basis":"no-additional-cost","cost_basis_label":"Included with a qualifying relationship","cost_basis_context":{"classification":"included","definition":"The benefit adds no separate charge, but the user must already have an eligible card, account, insurance plan, library card, membership, employment, or similar relationship that may itself cost money.","agent_instruction":"Say included or no additional cost, not universally free, and name the qualifying relationship.","variation_patterns":null,"does_not_mean":null},"fees":"Zero cost is not guaranteed in every case. Grandfathered or otherwise exempt plans, out-of-network care, diagnostic follow-up, services outside the listed criteria, and other care during the visit can create charges.","personalized":false,"regions":["US","Plan and provider-network availability"],"expires":null},"status":"verified","last_checked":"2026-08-04","claim_url":"https://www.healthcare.gov/coverage/preventive-care-benefits/","source_url":"https://www.healthcare.gov/coverage/preventive-care-benefits/","source":{"primary_url":"https://www.healthcare.gov/coverage/preventive-care-benefits/","evidence":[{"source":"Centers for Medicare & Medicaid Services","url":"https://www.healthcare.gov/coverage/preventive-care-benefits/","kind":"provider","checked_at":"2026-08-04"}]},"parent":null,"coverage":{"level":"national","family":"health-and-counseling","jurisdiction":"United States","maturity":"direct"},"web_url":"/benefits/health-plan-free-preventive-care","taxonomy":{"version":"1.0","url":"/api/v1/taxonomy"}}