But the second you mention some new issue that’s cropped up, it no longer coded as an annual checkup and you will be paying.

The only way to guarantee a free annual checkup is to go in, say nothing about your state of health, let the dr take your vitals and leave.

Is this universal?

In previous annual checkups with my primary care doctor, I have mentioned symptoms as varied as:

- recent depression

- trouble breathing

- irregular heartbeat

several of which resulted in follow-up appointments / lab work, but all of which were still covered 100% as annual checkups.

Do you have an ACA plan or employer provided insurance??

If you can find a doctor that takes your ACA plan then anything other than checking for a pulse is likely to result in some sort of bill.

Employer subsidized plans are also mostly compliant with ACA. Based on the trends in figure 13.3, I might even say less than 10% of Americans with employer subsidized health insurance are in non ACA compliant plans.

https://www.kff.org/report-section/2018-employer-health-bene...

And I have never had a doctor not accept an ACA compliant plan, which have been in the BCBS network for me.

This website seems to have a decent summary of coverage rules:

https://www.verywellhealth.com/aca-compliant-health-insuranc...

https://www.verywellhealth.com/preventive-care-whats-free-wh...

I don't mean ACA compliant. I mean actually purchased through the exchange, a.k.a Obamacare.

If your employer provided insurance it's good insurance, that's the perk of working there and part of your compensation.

If your employer doesn't provide it you have to buy during open enrollment through the exchange and the plans are terrible and expensive.

Of course, billing is by procedure done.

If you bring up a complaint, it's no longer a preventative check-up, it's addressing a complaint, which has a different billing code and different reimbursement.

Nope. The ACA doesn't classify annual checkups as preventative measures for adults.

https://www.healthcare.gov/preventive-care-adults/

I thought #4/5/15 effectively make it an annual check up.