Leslie Marisol Lugo

You booked your annual checkup expecting it to be free, but then a bill showed up, leaving you scratching your head. That doesn’t mean you did anything wrong, and you certainly are not alone in that experience. Rather, the confusion usually comes down to one distinction: preventive care versus diagnostic care. Preventive care is routine care meant to prevent disease or catch problems early, while diagnostic care evaluates a symptom, concern, or known condition.

If you’ve ever wondered whether there is a point when your insurance finally starts paying the full bill, the out-of-pocket maximum is the term you are looking for. Once you reach this limit, your health plan generally pays the full cost of covered, in-network care for the rest of the plan year. However, not every healthcare expense counts toward your out-of-pocket maximum.

You booked your annual checkup expecting it to be free, but then a bill showed up, leaving you scratching your head. That doesn’t mean you did anything wrong, and you certainly are not alone in that experience. Rather, the confusion usually comes down to one distinction: preventive care versus diagnostic care. Preventive care is routine care meant to prevent disease or catch problems early, while diagnostic care evaluates a symptom, concern, or known condition.