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Personal Finance (Not Investing) • ACA premiums 2026

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I don't know if this varies by state, or even by carrier within a state, but while the blood work associated my routine/annual physical is covered at 100%, if my doctor request a test as part of the panel that is not considered a covered service by my carrier, it will then be subject to the deductible and current insurance. It's not that it's considered medically ineligible, but that it's not covered as part of the routine exam.
I think that is consistent with what I've read. The distinction I've seen is proactive vs diagnostic testing. If you get routine blood work as part of your annual exam, it is proactive and therefore free. Anything that is diagnostic is subject to the deductible and co-pays.
Yes and no.

My internist has a standard panel that she requests for the annual physical each year. A few of those tests are not considered to be part of the defined routine benefit of my plan. They are no more diagnostic than the other tests she requests, but my carrier does not cover them as routine. In years that I have not met my deductible, it may cost me another $100+ OOP, but when I have satisfied my OOP, they are covered.

Statistics: Posted by HereToLearn — Thu Nov 06, 2025 10:06 pm — Replies 577 — Views 91807



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