Preventive care

The HealthPlus, Standard and Health+Savings Options provide coverage for the following preventive care services:

  • Routine physicals (once per calendar year).*
  • Routine well-child care.*
  • Annual well-woman exams.*
  • Routine mammograms.
  • Routine Prostate Specific Antigen (PSA) tests.
  • Colorectal screenings.
  • Routine hearing and vision chart exams (once per year).
  • Preventive items or services with an “A” or “B” rating from the United States Preventive Services Task Force.
  • Immunizations pursuant to the Advisory Committee on Immunization Practices (“ACIP”) recommendations.
  • Preventive care and screenings that are provided for in the comprehensive guidelines supported by the Health Resources and Services Administration (“HRSA”).
  • Gestational diabetes screening.
* Includes all tests (e.g., lab work, X-rays) associated with the visit and all office-based procedures.

Routine physicals are covered annually. Screenings and tests are covered based on age, gender and medical history.  Preventive care benefits are subject to age restrictions/limitations as determined under the claims administrator's guidelines. For additional information about benefits for covered preventive care services, contact the member services number on your medical ID card.

Routine physicals and well-child care include the following services:
  • Doctor's exam.
  • Immunizations.
  • Vision chart and hearing screenings performed in a doctor's office.

 

Publication date: April 2019

 

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