8 / 10
Your plan this year
Premium$400 / month
Deductible$2,000
Primary care copay$30
Coinsurance20%
Out-of-pocket max$6,000
💉
Situation 8 · October
You get a flu shot and your yearly checkup from in-network providers. You have no symptoms and raise no new problems. Your deductible is not met.
What do you pay?
Correct!
Not quite.
None of the five numbers applies. Most health plans must cover a list of preventive services, including routine vaccines and an annual wellness exam, with no copay, coinsurance or deductible when an in-network provider delivers them. Two things can change that: going out of network, or having the doctor evaluate a new problem during the visit, which can be billed separately.