As we move further into 2026, one of the most valuable benefits included in your health insurance plan is also one of the most overlooked: preventive care.
Scheduling a covered wellness visit with your in-network physician may require planning ahead. Many medical offices book annual exam appointments two to three months in advance. That is why it is smart to reserve your spot early rather than waiting until the end of the year.
What Preventive Care Really Means
All major medical plans that comply with the Affordable Care Act (ACA) are required to include ten essential health benefits. One of these core benefits is preventive services provided at no out-of-pocket cost when you use an in-network provider.
Preventive care focuses on early detection and risk reduction. Instead of addressing illness after it develops, these services are designed to catch potential concerns early or prevent them entirely. An annual wellness visit is not just paperwork—it is a comprehensive review of your health history, medications, risk factors, and recommended screenings based on age and gender.
Taking advantage of this benefit each year is one of the simplest ways to protect your long-term health.
How to Prevent Unexpected Charges
When booking your annual visit, inform the provider’s office that your appointment is strictly for preventive services. If you discuss a new medical concern or ask your doctor to evaluate specific symptoms, the provider may code the visit as diagnostic rather than preventive, which could trigger cost-sharing under your plan.
If your physician suggests lab work beyond standard screening guidelines, ask whether the tests qualify as preventive or diagnostic before proceeding. Clarifying this ahead of time can help you avoid surprise bills.
Your health plan covers preventive visits at 100% when you use an in-network provider.
Common Preventive Services Covered in 2026
California medical authorities and federal advisory panels set preventive care coverage standards, and regulators update these guidelines regularly. Comprehensive lists of covered preventive services are available for children, women, and the general adult population. Below are examples of services that California ACA-compliant health plans typically cover at no cost when you use an in-network provider.
Adults
- Annual wellness exam, including review of medical history and risk assessment
- Blood pressure and cholesterol screening
- Diabetes screening (based on age and risk factors)
- Colon cancer screening beginning at age 45
- Lung cancer screening for eligible high-risk individuals
- Routine immunizations (flu, hepatitis A & B, MMR, shingles, COVID updates as recommended)
Women
- Well-woman exam
- Mammogram (generally beginning at age 40, earlier if high risk)
- Cervical cancer screening (Pap test and HPV testing per guidelines)
- Contraceptive counseling and FDA-approved contraceptive methods
- Screening for osteoporosis beginning at recommended ages
Men
- Prostate cancer screening discussion (age and risk-based)
- Abdominal aortic aneurysm screening for eligible individuals
Children & Adolescents
- Well-child visits
- Developmental screenings
- Routine childhood vaccinations
California continues to emphasize access to preventive services. State-regulated health plans must provide coverage for many preventive treatments without cost-sharing, including reproductive healthcare services, HIV prevention medications such as PrEP, and certain STI screenings.
While healthcare regulations can evolve at both the federal and state level, ACA-compliant plans in 2026 continue to offer first-dollar coverage for recommended preventive services when obtained in-network.
A Proactive Approach to 2026
Preventive care keeps you healthy instead of just treating illness. A single annual appointment can provide reassurance, identify concerns early, and help you stay on track for the year ahead.
If you have questions about what your specific 2026 plan covers or would like assistance reviewing your benefits, please contact Solid Health Insurance Services at 310-909-6135 or email info@solidhealthinsurance.com.
At Solid Health Insurance Services, we help you choose health, dental, vision, life, and long-term care coverage that supports your well-being and fits your budget.
Taking a proactive step today can make all the difference tomorrow.