There is no obligation on health plans to provide these services out of network. Business Insurance explains that
The regulations * * * make clear that regular cost-sharing requirements can be imposed on an office visit when a recommended preventive service is billed as a separate charge.As mentioned yesterday, the FEHB plan already offers generous in-network preventive services coverage.
In addition, treatment resulting from a preventive service can be subject to cost-sharing requirements if the treatment is not itself a recommended preventive service.
Regulators estimate that the new requirements will increase group health care plans’ costs by an average of 1.5% a year.
Mike Thompson, a principal with PricewaterhouseCoopers L.L.P. in New York said, though, the cost impact will be much lower for employers that already provide coverage for many preventive services.