The Myth of Free Preventive Health Care & Obamacare

Medical bills and stethoscpoe.

If you think that the Affordable Care Act made preventive health care free for people with health insurance, you’re wrong. In fact, free preventive care with Obamacare is a myth. Very few things in life are free, and preventive health care isn’t one of them, with or without Obamacare.

So, why all of the confusion and what, exactly, does the Affordable Care Act say about preventive care? The confusion is over what free care really means.

To most consumers, free means you don’t have to pay for something. That’s not exactly the same as saying, “You don’t have to pay for something right now,” which is essentially what the Affordable Care Act says about preventive health care.

The Affordable Care Act stipulates that health insurers must cover certain preventive health care services; they’re considered one of the 10 essential health benefits. It also stipulates that health insurers can’t charge cost-sharing fees for preventive care services. However, it doesn’t say that health insurers can’t charge for preventive care services, just that they can’t require that a deductible be paid before covering preventive care and can’t require copays or coinsurance for preventive care.

In fact, health insurers don’t just give preventive health care benefits away for free. They’d go out of business if they gave stuff away for free, and then nobody would have health insurance.

Instead of requiring cost-sharing for preventive care, health insurers include the anticipated cost of preventive care services into the premiums they charge for the health insurance coverage.  Preventive services are included in the actuarial value calculations for each health plan, and the premium charged for that health plan reflects, in part, the cost of providing your preventive health care services without requiring any cost-sharing.

You pay for the cost of your preventive health services each month when you pay your monthly health insurance premium…whether or not you actually take advantage of the preventive health benefits that are included in your health insurance coverage.

Even if you’re getting help paying for health insurance such as the premium tax credit health insurance subsidy, your preventive care still isn’t free. You pay part of the cost of it with the reduced monthly premiums you pay for health insurance; the government pays part of the cost of it with the subsidy.

Learn more about how health insurance covers preventive care, what’s covered by health insurance without cost-sharing, and what’s not:

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