Updated August 2026 for the current plan year.

Here is something a lot of South Carolinians pay for without needing to: ACA plans are required to cover a list of preventive services at no cost to you when you stay in network. No copay, and no need to meet your deductible first.

This is not a promotion or a limited-time benefit. It is built into the plan. The catch is that most people never find out what is on the list, so they skip the appointment or pay for something that was already covered.

Nine worth knowing.

1. Your annual wellness visit. A yearly sit-down with your doctor to review how you are actually doing, set a plan, and catch anything drifting in the wrong direction. This is the appointment everything else tends to get scheduled from.

2. Vaccines. Routine immunizations recommended for adults and children, including flu, tetanus, shingles, and others depending on your age. Covered in full in network.

3. Blood pressure screening. High blood pressure has no symptoms until it does. The check takes a minute and it is covered.

4. Cholesterol screening. Frequency depends on your age and risk factors. Knowing the numbers is what makes the rest of the conversation possible.

5. Cancer screenings. Depending on age and history, this can include mammograms, cervical cancer screening, colorectal screening, and lung cancer screening for people who qualify by smoking history. These are the ones where early detection changes outcomes most.

6. Depression and mental health screening. Covered for adults and adolescents. Worth using.

7. Tobacco cessation counseling. Counseling, and often the medications that go with it, at no cost.

8. Child wellness visits. Regular checkups tracking growth and development, plus the vision and hearing screenings that go with them.

9. Women’s health services. Well-woman visits, contraception, screening during pregnancy, and breastfeeding support, depending on age and circumstance.

Why people still get a bill

Almost always because of how the visit was coded, and it is worth understanding before your next appointment.

A screening test ordered because you are due for it is preventive. The same test ordered because you have symptoms is diagnostic, and diagnostic care runs through your normal deductible and copays. A colonoscopy scheduled at the recommended age is preventive; one scheduled because something is wrong is not.

The other common surprise: bringing up a new problem during your annual physical. That can add a billable office visit on top of the covered preventive one. It is not a trick, it is two different services happening in the same room.

The practical move: ask when you schedule whether the visit will be billed as preventive, and confirm your provider is in network. Two questions, and they prevent nearly all of these bills.

What is not covered this way

Short-term plans and healthcare sharing ministries are not ACA plans. They are not required to cover any of this, and generally do not. If preventive coverage matters to you, that difference is worth weighing before you buy one.

Using it

If you already have a Marketplace plan, you can use these services now. Log into your plan’s portal, find the in-network provider list, and book the annual visit you have been putting off.

If you do not have coverage yet, Open Enrollment for 2027 coverage runs November 1 through December 15, 2026, with coverage starting January 1. Our Open Enrollment guide covers what to compare, and HMO, PPO, and POS explained covers how networks differ, which matters here because the no-cost rule depends on staying in network.

Frequently asked questions

Are preventive services really free, or do they just count toward my deductible? Genuinely no cost-sharing, when you use an in-network provider and the service is on the required list. You do not pay a copay, and you do not have to meet your deductible first. That is a requirement of the plan, not a promotion.

Why did I get a bill after a free preventive visit? Usually because something got coded as diagnostic rather than preventive. A screening colonoscopy is preventive; one ordered because you have symptoms is diagnostic. Discussing a new problem during an annual physical can also add a billable office visit. Ask how a visit will be coded before it happens.

Does this apply to every plan? It applies to ACA-compliant plans, which includes every Marketplace plan and most employer coverage. It does not apply to short-term plans or healthcare sharing ministries, which are not ACA plans and are not required to cover any of it.

What if my doctor is out of network? Then the no-cost rule generally does not apply. Preventive services are only guaranteed without cost-sharing in network, so confirm the provider is in your plan’s network before the appointment, not after.

Not sure what your plan actually covers? Call or text 803-848-0089, or start on our health insurance page. We will read your plan with you and tell you what you are already entitled to, no charge.