°Õ³ó±ðÌý explicitly allow an annual well-woman visit for recommended preventive services. Coverage for annual physicals for men isn’t required under the law, but  say that office visits that are primarily preventive in nature may be covered without any patient cost sharing, says Adam Sonfield, a senior public policy associate at the Guttmacher Institute who has written extensively about the law’s preventive coverage requirements.

If, in addition to a routine physical exam, your doctor also provides  or other higher level services related to your chronic conditions, you may be charged for that portion of the office visit, say primary care practice specialists. It will likely depend on whether the physician bills separately for those services in addition to the routine physical exam.

In your case, the extra charge was a $20 copay. But depending on how a health plan is structured, other people might be on the hook for a much larger charge. If a plan has an “all-inclusive” deductible, “the insurance coverage does not kick in until you meet it, meaning all other office visits, lab work [and the like] are subject to that deductible,” says Jennifer Tolbert, director of state health reform at the Kaiser Family Foundation. (KHN is an editorially independent program of the foundation.)

Of course, an argument can be made that managing someone’s chronic conditions is preventive.

“Clearly, for this person managing the chronic disease is really important, because it prevents a worsening of the disease,” says Sonfield. But not everyone agrees with that interpretation. Besides, if that’s considered prevention, “Where do you draw the line?”