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I called to make an appointment for my free annual wellness visit.* They said because my primary care physician (PCP) left the practice, they would not be able to give me the free annual wellness visit until I first make a paid appointment to establish a relationship with a different doctor.

What they did sounds fishy and shady. My question is, does the Affordable Care Act really have a provision saying they can deny me a free annual wellness visit just because my PCP left the practice?


* I believe I am entitled to a free annual wellness visit, because according to https://obamacarefacts.com/obamacare-preventive-care,

"FACT: At least 15 free preventive services and one wellness visit are covered on major medical plans sold after 2014 without copays and coinsurance, regardless of whether you have met your deductible yet."

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  • Note that your link is an unofficial non-government site. Commented Nov 5, 2021 at 23:33
  • Keep in mind there are two different "they" here - the insurer, and the provider (the medical practice). The insurer does have to pay for a wellness visit, once you manage to get one. Whether the doctor actually has to provide one is an entirely separate question. Commented Nov 5, 2021 at 23:37
  • I believe the Affordable Care Act's requirement to provide certain preventative measures at no cost applies to everyone, not just insured people. So wouldn't that put the onus of providing those measures on the healthcare provider? Commented Nov 8, 2021 at 16:20
  • What's your source for that? The link you quote from specifically says these services are covered on major medical plans. There's nothing about providing these services to the uninsured. AFAIK, the ACA's provision for the uninsured was only to create a number of ways for them to become insured. Commented Nov 8, 2021 at 16:43
  • Normally, payment for a wellness visit is an issue with the insurance company and not with the healthcare provider itself, except in the case of Kaiser Permanente which is one of the only vertically integrated insurance companies and health care providers.
    – ohwilleke
    Commented Nov 8, 2021 at 19:25

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