Free and low-cost health screenings, tests and shots: who qualifies and where to go
Most health plans must cover recommended screenings, checkups and shots with no copay or deductible when you use an in-network provider. Medicare and Medicaid cover many of them too. Without insurance, health centers charge by income, and federal programs offer no-cost or low-cost mammograms, Pap tests, birth control and children's vaccines if you qualify.
Your options, cheapest first
Start at the top. Stop at the first route that fits you. This guide is about cost and access. Which screenings you need depends on your age, sex, health and family history, so ask a doctor or nurse.
The preventive benefit in your health plan
- Who qualifies
- People with a Marketplace plan and most job-based or other private plans. Older "grandfathered" plans don't have to offer free preventive care (HealthCare.gov). If you're not sure, ask your plan or your employer.
- What it costs
- No copay, coinsurance or deductible for the services on the federal list, if you use a provider in your plan's network (45 CFR 147.130 (law.cornell.edu)). You may still owe money for extra tests, or for a visit that was mainly about another problem.
- How to get it
- Book with an in-network provider and say you want a preventive visit or screening.
Medicare (if you have it)
- Who qualifies
- People with Medicare. Part B covers most screenings. A Medicare drug plan covers some vaccines, such as the shingles shot.
- What it costs
- You pay nothing for most preventive services if your provider accepts assignment. That includes a yearly wellness visit (Medicare.gov). Medicare drug plans must offer the adult vaccines CDC recommends at no cost, except the ones Part B covers (CDC (cdc.gov)).
- How to get it
- Ask your provider if they accept assignment. For questions, use Medicare's help line (medicare.gov) or free counseling from SHIP (shiphelp.org). Not sure if you have Medicare or Medicaid? See how the two programs differ.
Programs for people without insurance
- Who qualifies
- It depends on the program. Most look at your income, your age and whether you have insurance. See "Who qualifies" below.
- What it costs
- Nothing or a reduced fee, if you meet the program's rules.
- How to get it
- Call the program or clinic first. The steps below show who to call for each service.
A community health center or free clinic
- Who qualifies
- Health centers see anyone, with or without insurance. Free clinics set their own rules about who they see.
- What it costs
- Community health centers charge on a sliding scale based on income; some visits cost little or nothing. Free clinics set their own fees.
- How to get it
- Find one on HRSA's health center finder (findahealthcenter.hrsa.gov) or the free clinic finder (nafcclinics.org), then call ahead. Our guides to community health centers and free clinics explain what to expect.
Coverage that includes preventive care
- Who qualifies
- People who qualify for Medicaid or CHIP, or who buy a Marketplace plan.
- What it costs
- Medicaid and CHIP are free or very low cost for people who qualify. Rules depend on your state, income and household size. A Marketplace plan has a monthly premium, the amount you pay each month to keep the plan.
- How to get it
- Apply for Medicaid or CHIP any time of year through your state or HealthCare.gov. Start with how Medicaid works. To buy a Marketplace plan, use HealthCare.gov or your state's official marketplace. You can sign up during Open Enrollment, or after a big life change such as losing other coverage.
With a plan or without one: where each service can cost nothing
This table puts two routes side by side for common screenings and shots. The middle column shows what most health plans must cover with no cost sharing (no copay, coinsurance or deductible) when you see an in-network provider. The right column shows where to go if you don't have insurance, and the rules you must meet.
| Service | With most health plans (in network) | Without insurance |
|---|---|---|
| Blood pressure check | Covered for adults and for children. | Community health centers, on a sliding fee by income. Free clinics. |
| Mammogram | Every 1 to 2 years for women 40 and older. | CDC's breast and cervical cancer program, for women 40 to 64 with income at or below 250% of the poverty guideline and no coverage for screening. |
| Pap test (cervical cancer screening) | Women 21 to 65. | The same CDC program, for ages 21 to 64. Title X family planning clinics. |
| Colorectal cancer screening | Adults 45 to 75. | Community health centers, on a sliding fee. Ask your local health department about programs near you. |
| HIV and other STI tests | HIV screening for everyone 15 to 65. Syphilis, chlamydia and gonorrhea screening for some groups, such as younger women and people at higher risk. | Title X clinics. Clinics on CDC's GetTested finder, many of them free or low cost. |
| Birth control | FDA-approved methods prescribed for women. Some religious employers are exempt. | Title X clinics: no charge at or below 100% of the poverty guideline, and discounts up to 250%. |
| Flu shot and other adult vaccines | Vaccines that CDC's vaccine advisory committee recommends. | Community health centers, on a sliding fee. Health departments may point you to free or low-cost shots. |
| Children's checkups and vaccines | Well-child visits, and recommended vaccines from birth to 18. | Vaccines for Children: the vaccine costs nothing for children 18 and under who are uninsured, underinsured, eligible for Medicaid, or American Indian or Alaska Native. The provider may charge a fee for giving the shot. |
How to read this: if you have a plan, the middle column is usually your cheapest route, as long as you stay in network. Without insurance, each program on the right has its own rules. For example, a household of three with $50,000 a year in income is at about 183% of the 2026 poverty guideline of $27,320 (ASPE (aspe.hhs.gov)). That is under the 250% limit for the CDC program. It is also under the 200% limit for a health center's sliding discount, so the fee there would be reduced. But it is over the 100% limit for no-charge Title X care, so a Title X clinic would charge a discounted fee.
Plan rules come from HealthCare.gov's lists for adults (healthcare.gov), women (healthcare.gov) and children (healthcare.gov). Program rules come from CDC (cdc.gov), 42 CFR 59.2 (law.cornell.edu) and 59.5 (law.cornell.edu), 42 CFR 51c.303 (law.cornell.edu) and CDC's Vaccines for Children rules (cdc.gov).
Guides in this section
- Flu shots at no cost: where a flu shot costs nothing, whether you have a plan, Medicare, Medicaid or no coverage.
For mammograms, Pap tests, STD and HIV tests, birth control and children's vaccines, use the sections below.
Free health screenings if you don't have insurance: who qualifies
Each program has its own rules. Most use the federal poverty guideline (FPL), a yearly income amount that HHS sets for each household size.
Mammograms and Pap tests: CDC's breast and cervical cancer program
You may qualify for free or low-cost screening through the National Breast and Cervical Cancer Early Detection Program if all three are true (CDC (cdc.gov)):
- You have no insurance, or your plan doesn't cover screening.
- Your yearly income is at or below 250% of the poverty guideline.
- You are 40 to 64 for a mammogram, or 21 to 64 for a Pap test. Some younger or older women may also qualify.
| Household size | Income limit (at or below 250% of poverty) |
|---|---|
| 1 | $39,900 |
| 2 | $54,100 |
| 3 | $68,300 |
| 4 | $82,500 |
- Income limit (at or below 250% of poverty): Also: no insurance or insurance that doesn't cover screening; ages 40-64 (breast) or 21-64 (cervical). Some states use different limits.
For example, a woman in a household of two with $50,000 a year in income is under the $54,100 limit for that size. The program also offers follow-up tests if a result isn't normal.
Birth control, STI tests and Pap tests: Title X clinics
Title X family planning clinics can't charge people whose household income is at or below 100% of the poverty guideline (42 CFR 59.2 (law.cornell.edu)). That is $15,960 a year for one person in 2026. They may still bill your insurance or Medicaid if you have it. From there up to 250%, fees follow a discount schedule based on what you can pay (42 CFR 59.5 (law.cornell.edu)). If the clinic can't confirm your income, it must base the fee on the income you report. Besides birth control, these clinics may offer STI services, HPV shots and breast and cervical cancer screening (Office of Population Affairs (opa.hhs.gov)). Call ahead to confirm what a clinic offers.
Children's vaccines: Vaccines for Children
Children 18 and under can get the vaccine itself at no cost from a provider in the Vaccines for Children program if they are uninsured, eligible for or enrolled in Medicaid, American Indian or Alaska Native, or underinsured (CDC (cdc.gov)). Underinsured means the child's plan doesn't fully cover vaccines. Those children get the vaccines at a health center, a rural health clinic or another approved site. Children in a separate CHIP program count as insured and don't qualify.
The provider may charge a fee for giving the shot. But it can't refuse to vaccinate your child because you can't pay that fee. Other services at the visit, such as a blood test, may cost extra. If your child doesn't have Medicaid, you may also have to pay for the office visit (CDC (cdc.gov)). Ask about those costs when you book.
Everything else: community health centers
Federally funded health centers must offer preventive care. That includes cancer screening, well-child care, vaccines and family planning (42 U.S.C. 254b (law.cornell.edu)). At or below 100% of the poverty guideline you get a full discount, though the center may charge a small fee. Sliding discounts go up to 200%. No one can be turned away for being unable to pay (42 CFR 51c.303 (law.cornell.edu)).
How to get a screening at no cost or low cost
If you have a health plan
- Find your plan's list of preventive services, or call the member services number on your card.
- Pick a doctor, clinic or lab in your plan's network. Plans don't have to cover out-of-network screenings this way, unless they have no in-network provider for that service.
- When you book, say it's a preventive visit or a screening.
- If the provider adds a test during the visit, ask if it is preventive or meant to check a problem. Tests for a problem can come with a copay or deductible.
- Read the Explanation of Benefits your plan mails or posts after the visit. If it shows a charge for a preventive service, see the next section.
If you don't have insurance
- For a mammogram or Pap test, pick your state on CDC's breast and cervical cancer program page (cdc.gov) and call the number it lists.
- For birth control or STI tests, search the Title X clinic finder (opa-fpclinicdb.hhs.gov) or CDC's GetTested (gettested.cdc.gov).
- For a child's vaccines, ask your state or local health department for a Vaccines for Children provider.
- For a checkup, a blood pressure check or other screenings, find a health center on HRSA's finder (findahealthcenter.hrsa.gov) or a free clinic on the free clinic finder (nafcclinics.org). Ask about the sliding fee when you call.
- If you will pay yourself, ask for a Good Faith Estimate. Providers must give you one if you book at least 3 business days ahead, or if you ask (CMS (cms.gov)).
What to bring
- Your insurance, Medicaid, CHIP or Medicare card, if you have one.
- A photo ID, if you have one. If not, ask what the clinic accepts.
- Proof of household income, such as pay stubs, a tax return or a benefits letter. Programs and sliding fees use it. If you don't have proof, call anyway and ask what else they accept.
- Dates and results of past screenings, if you know them.
- Your child's vaccine record.
- Any Good Faith Estimate you were given.
What to say when you call
With a plan: "Hi, I'd like to book a [screening or checkup]. I have [plan name]. Are you in my plan's network? Will this visit be billed as preventive care?"
Without insurance: "Hi, I don't have insurance. Do you have a sliding fee for [screening]? Can you check if I qualify for a program like the breast and cervical cancer program or Title X? What should I bring?"
Rules that changed recently (as of October 2026)
Screenings. In June 2025, the U.S. Supreme Court ruled that the members of the U.S. Preventive Services Task Force were appointed lawfully (Kennedy v. Braidwood Management (supremecourt.gov)). The task force rates screenings. The law still says plans must cover the ones it rates A or B with no cost sharing (42 U.S.C. 300gg-13 (law.cornell.edu)).
Vaccines. Plans must cover the shots that CDC's vaccine advisory committee recommends. Those recommendations changed several times in 2025 and 2026. In March 2026, a federal court put many of those changes on hold while a lawsuit goes on (Congressional Research Service (everycrsreport.com)). The rules may change again. Before you get a shot, ask your plan, pharmacy or clinic if it is covered with no cost sharing.
Medicaid and CHIP. Since Oct. 1, 2023, Medicaid and CHIP must cover adult vaccines that the committee recommends, with no cost sharing (CMS letter SHO 23-003 (medicaid.gov)).
If you get a bill or are turned down
- Call the provider's billing office. Ask how the visit was coded. If a screening was billed as a visit for a problem, ask them to fix the code and send a new claim.
- Call your plan. Ask why you were charged. Under the federal rules, a charge can apply if the provider was out of network, if the visit was mainly about another problem, or if other tests were done (45 CFR 147.130 (law.cornell.edu)). If none of those apply, say so and ask the plan to reprocess the claim.
- Appeal. If your plan denies the claim, you can file an internal appeal within 180 days of the denial notice (HealthCare.gov). If the plan says no again, you can ask for an external review by an independent reviewer (HealthCare.gov).
- With Medicare. Call 1-800-MEDICARE (medicare.gov), or get free one-on-one help from your state's SHIP (shiphelp.org).
- Without insurance. If a bill is at least $400 more than the Good Faith Estimate from that provider, you can dispute it within 120 days of your first bill (CMS (cms.gov)). For a hospital bill, ask about hospital financial assistance. For other bills, see our guide to help with medical bills.
- If a screening finds a problem. CDC's breast and cervical cancer program also offers diagnostic tests. A federal law lets states give Medicaid treatment to women diagnosed with cancer through the program (CDC (cdc.gov)). Ask your state program how that works where you live. A health center's sliding fee applies to its follow-up care too.
Find it near you (official and nonprofit finders)
- HRSA Find a Health Center (findahealthcenter.hrsa.gov)Search by address or ZIP code; results list federally funded health centers by distance.
- NAFC Find a Free Clinic (nafcclinics.org)Search by city or ZIP code; call the clinic before you go, because hours and rules vary.
- OPA Find a Family Planning Clinic (Title X) (opa-fpclinicdb.hhs.gov)Search by location for Title X family planning clinics.
- CDC National Breast and Cervical Cancer Early Detection Program (cdc.gov)Pick your state on CDC's page to get your local program's phone number.
How we researched this: we checked each rule and number on this page against the federal rules and program pages listed under Sources on October 19, 2026. This guide explains cost and access. It is not medical advice.
Common questions
- What is a health screening?
- A test or exam that looks for a health problem before you have symptoms, such as a blood pressure check, a mammogram or an HIV test. Screenings are one kind of preventive care (healthcare.gov). Checkups, shots and some counseling count too.
- Is preventive care free if you have insurance?
- Usually, if your plan follows the Affordable Care Act and you use an in-network provider. Then you pay no copay, coinsurance or deductible for the services on the federal list. You may still pay if the visit was mainly about another problem, if the provider adds other tests, or if you have an older grandfathered plan.
- Do children get free checkups with CHIP or Medicaid?
- Yes, if they are enrolled. CHIP can't charge copays, deductibles or coinsurance for well-baby and well-child care, and that includes recommended shots (42 CFR 457.520 (law.cornell.edu)). Medicaid can't charge for that preventive care for children under 18 (42 CFR 447.56 (law.cornell.edu)). Medicaid also covers checkups and vision, hearing and dental screenings for children under 21 through a benefit called EPSDT (Medicaid.gov).
- Does Medicaid cover preventive care for adults?
- Medicaid must cover family planning, with no copay (42 CFR 447.56 (law.cornell.edu)). Many other adult screenings are an optional benefit, so what is covered depends on your state (Medicaid.gov). But adults covered through Medicaid expansion get a benefit package that must include preventive and wellness services (42 CFR 440.347 (law.cornell.edu)). Most adults on Medicaid get CDC-recommended vaccines at no cost (CDC (cdc.gov)). Ask your state Medicaid agency or your health plan what your coverage includes.
- Where can I get a health screening if I don't have insurance?
- Start with a community health center, which charges on a sliding scale based on income; some visits cost little or nothing. For mammograms and Pap tests, call your state's breast and cervical cancer program. For birth control and STI tests, try a Title X clinic. For a child's vaccines, ask for a Vaccines for Children provider.
Sources
- HealthCare.gov, Preventive health services, accessed October 19, 2026
- HealthCare.gov, Preventive care benefits for adults, accessed October 19, 2026
- HealthCare.gov, Preventive care benefits for women, accessed October 19, 2026
- HealthCare.gov, Preventive care benefits for children, accessed October 19, 2026
- HealthCare.gov glossary, Preventive services, accessed October 19, 2026
- HealthCare.gov, Grandfathered health insurance plans (protections they don't have to offer), accessed October 19, 2026
- 45 CFR 147.130, Coverage of preventive health services (Cornell LII) (law.cornell.edu), accessed October 19, 2026
- 42 U.S.C. 300gg-13, Coverage of preventive health services (Cornell LII) (law.cornell.edu), accessed October 19, 2026
- Supreme Court of the United States, Kennedy v. Braidwood Management, No. 24-316 (decided June 27, 2025) (supremecourt.gov), accessed October 19, 2026
- Congressional Research Service, Changes to CDC Vaccine Recommendations in 2025 and 2026 (Insight IN12684, updated July 29, 2026; EveryCRSReport copy, congress.gov blocks automated fetches) (everycrsreport.com), accessed October 19, 2026
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- CMS, SHO #23-003, Mandatory Medicaid and CHIP coverage of adult vaccinations under the Inflation Reduction Act (June 27, 2023) (medicaid.gov), accessed October 19, 2026
- 42 CFR 457.520, CHIP cost sharing for well-baby and well-child care (Cornell LII) (law.cornell.edu), accessed October 19, 2026
- 42 CFR 447.56, Medicaid limitations on premiums and cost sharing (preventive services for children under 18; family planning) (Cornell LII) (law.cornell.edu), accessed October 19, 2026
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- CDC, About the National Breast and Cervical Cancer Early Detection Program (updated Sept 18, 2026) (cdc.gov), accessed October 19, 2026
- 42 CFR 59.2, Title X definitions (low-income family: at or below 100% of the poverty guidelines) (Cornell LII) (law.cornell.edu), accessed October 19, 2026
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