Preventive care
Preventive care services for members
How can I get preventive care?
Avoid extra health care costs
These benefits, identified by the ACA as preventive care, are available for members of non-grandfathered individual health insurance plans.
If you get benefits from your employer, you may also have these benefits. If the Summary of Benefits section of your Blue Cross and Blue Shield of North Carolina (Blue Cross NC) Benefit Booklet contains "Preventive Care" covered under federal law, then you have these benefits at no charge, when they are performed in-network.
These benefits are currently in effect unless otherwise noted.
Check your Benefit Booklet for details on other preventive care benefits.
This information is a reference tool and does not guarantee payment of any claims.
These may cost you money at your doctor’s office or lab:
- Chest X-rays
- Thyroid tests
- EKGs (electrocardiograms)
- Urine tests
- Hormone tests
- Vitamin D tests
- Tell the person who answers your call: "I want preventive care screenings and tests that are 100% covered by my plan."
- Ask the person who is scheduling your appointment: "Is my doctor in my plan’s network?"
- Will any additional tests or treatments I get during my appointment not be considered preventive care?
- Will talking about other topics that are not considered preventive care during my appointment lead to out-of-pocket costs?
- Can any routine lab work be sent to a Blue Cross NC in-network lab to lower my out-of-pocket costs?
Looking for covered medications?
Under the Affordable Care Act, some medications are covered at 100% on all prescription drug lists or formularies.
These medications include aspirin, certain supplements, tobacco cessation support, and some contraceptives.
For drug and dosage details, refer to the Affordable Care Act (ACA) Preventive Drug List:
Frequently asked questions
The Affordable Care Act (ACA) has identified certain services as preventive care services paid at 100%. This information is a reference tool and does not guarantee payment of any claims.
- These benefits are available for members of non-grandfathered individual health insurance plans. These benefits may not apply to grandfathered members.
- If you get benefits from your employer, you may also have these benefits. If the Summary of Benefits section of your Benefit Booklet contains preventive care covered under federal law, then you have these benefits at no charge when you use an in-network provider.
- These benefits are currently in effect unless otherwise noted.
- Log in to your member portal to check your Benefits Booklet for details on other preventive care benefits.
- For transgendered individuals, you have access to medically appropriate preventive services.