How are preventive services treated under most ACA-compliant plans with respect to cost-sharing when delivered by an in-network provider?

• A. Preventive services are provided with a copay for in-network visits.
• B. No cost-sharing for preventive services when delivered by an in-network provider according to USPSTF/ACIP guidelines.
• C. Preventive services require deductible payment before coverage.
• D. Preventive services are not covered at all.

Answer: (B)

Under ACA-compliant plans, preventive services that have a USPSTF or ACIP recommendation and are provided by an in-network provider are covered with no cost-sharing. That means you won’t pay a deductible, copay, or coinsurance for those in-network preventive services. The key is staying in-network and ensuring the service is one of the covered preventive items. If you go out-of-network, or the service isn’t on the recommended list, or it’s performed for a non-preventive reason, cost-sharing can apply.