Preventive Health Services
All of our plans offer access to top-quality doctors and hospitals, plus free coverage for preventive care. Free. And we mean it. These services are covered from day one and are offered by doctors and providers within your plan's network.
Most Common FREE† Preventive Services
- Annual Routine Checkup*
- Cholesterol Screening
- Colonoscopy Screening
- Diabetes Screening
- Contraceptive Methods & Counseling
- Immunizations
- Mammography Screening
- Prostate Testing
- Well-Child Visit*
- Well-Woman Visit*
Prioritize your preventive care plan of action with our Preventive Care Checklists. These checklists make it easier to keep the most essential screenings and doctor visits top of mind.
- Child Preventive Health Checklist (English)Open a PDF
- Child Preventive Health Checklist (Spanish)Open a PDF
- Adult Preventive Health Checklist (English)Open a PDF
- Adult Preventive Health Checklist (Spanish)Open a PDF
†A well visit or preventive service can sometimes turn into a “sick visit”, in which out-of-pocket expenses for deductible, copay and/or coinsurance may apply. There may also be other services performed in conjunction with the above preventive care services that might be subject to deductible, copay and/or coinsurance.
* Does not include procedures, injections, diagnostic services, laboratory and X-ray services, or any other services not billed as preventive services.
- Abdominal aortic aneurysm one-time screening for men of specified ages who have ever smoked
- Alcohol misuse screening and counseling
- Aspirin use to prevent cardiovascular disease and colorectal cancer for adults 50 to 59 years with a high cardiovascular risk
- Blood pressure screening
- Cholesterol screening for adults of certain ages or at higher risk
- Colorectal cancer screening for adults 50 to 75
- Depression screening
- Diabetes (Type 2) screening for adults 40 to 70 years who are overweight or obese
- Diet counseling for adults at higher risk for chronic disease
- Falls prevention (with exercise or physical therapy) for adults 65 years and over, living in a community setting
Note: The United States Preventive Services Task Force has determined that taking a Vitamin D supplement is not shown to have any benefit in fall prevention in older adults. For members who are taking an over-the-counter Vitamin D supplement, the supplement will no longer be covered starting August 1, 2018. If members choose to continue taking a Vitamin D supplement, they will be responsible for the full cost. For members who have a prescription version from their physician for Vitamin D, they will be charged the appropriate cost sharing amount for their drug plan.
- Hepatitis C screening
- HIV screening for everyone ages 15 to 65, and other ages at increased risk
-
Immunization vaccines for adults — doses, recommended ages, and recommended populations vary:
- Diphtheria
- Hepatitis A (including all persons aged one year and older experiencing homelessness should be routinely immunized against Hepatitis A)
- Hepatitis B
- Herpes Zoster
- Human Papillomavirus (HPV)
- Influenza (flu shot)
- Measles
- Meningococcal
- Mumps
- Pertussis
- Pneumococcal
- Rubella
- Tetanus
- Varicella (Chickenpox)
- Lung cancer screening for adults 55-80 at high risk for lung cancer because they’re heavy smokers or have quit in the past 15 years
- Obesity screening and counseling
- Sexually transmitted infection (STI) prevention counseling for adults at higher risk
- Skin cancer screening counseling interventions on increasing sun protection behaviors
- Statin preventive medication for adults 40 to 75 at high risk
- Syphilis screening for adults at higher risk
- Tobacco use screening for all adults and cessation interventions for tobacco users
- Tuberculosis screening for certain adults without symptoms at high risk
- Anemia screening on a routine basis
- Breastfeeding comprehensive support and counseling from trained providers, and access to breastfeeding supplies, for pregnant and nursing women
- Contraception: Food and Drug Administration-approved contraceptive methods, sterilization procedures, and patient education and counseling, as prescribed by a health care provider for women with reproductive capacity (not including abortifacient drugs). This does not apply to health plans sponsored by certain exempt “religious employers.”
- Counseling interventions for pregnant and postpartum persons who are at increased risk of perinatal depression
- Expanded tobacco intervention and counseling for pregnant tobacco users
- Folic acid supplements for women who may become pregnant
- Gestational diabetes screening for women 24 to 28 weeks pregnant and those at high risk of developing gestational diabetes
- Gonorrhea screening for all women at higher risk
- Hepatitis B virus infection in pregnant women at their first prenatal visit and in persons at high risk for infection. In addition, vaccination and HBIG for:
- Infants born to women whose HBsAg status is unknown, but where evidence suggests HBsAg-positive status, within 12 hours of birth.
- Medically stable newborns born to HBsAg negative mothers weighing at least 2,000 grams within 24 hours of birth, as well as vaccination of previously unvaccinated children and adolescents. As well as post-vaccination testing and revaccination if necessary.
- Plans must also now cover a single-dose revaccination for infants born to HBsAg-positive women who are not responding to the initial series & Adults and Adolescents.
- In addition to covering vaccines for people at risk for Hepatitis B, Plans will now be required to cover vaccination of people with chronic liver disease.
- Preeclampsia prevention and screening for pregnant women with high blood pressure
- Rh incompatibility screening for all pregnant women and follow-up testing for women at higher risk
- Syphilis screening
- Urinary tract or other infection screening
Other covered preventive services for women
- Breast cancer genetic test counseling (BRCA) for women at higher risk
- Breast cancer mammography screenings every 1 to 2 years for women over 40
- Breast cancer chemoprevention counseling for women at higher risk
- Cervical cancer screening
- Pap test (also called a Pap smear) every 3 years for women 21 to 65
- Human Papillomavirus (HPV) DNA test with the combination of a Pap smear every 5 years for women 30 to 65 who don’t want a Pap smear every 3 years
- Chlamydia infection screening for younger women and other women at higher risk
- Diabetes screening for women with a history of gestational diabetes who aren’t currently pregnant and who haven’t been diagnosed with type 2 diabetes before
- Gonorrhea screening for all women at higher risk
- HIV screening and counseling for sexually active women
- Maternal Depression Screening
- Rh incompatibility screening follow-up testing for women at higher risk
- Screening for Intimate Partner Violence and Elder Abuse in women of reproductive age and provide or refer women who screen positive to ongoing support services
- Screening for osteoporosis with bone measurement testing to prevent osteoporotic fractures in postmenopausal women younger than 65 years who are at increased risk of osteoporosis, as determined by a formal clinical risk assessment tool, and screening for osteoporosis with bone measurement testing to prevent osteoporotic fractures in women 65 years and older.
- Sexually transmitted infections counseling for sexually active women
- Skin cancer screening counseling interventions on increasing sun protection behaviors
- Syphilis screening for women at increased risk
- Tobacco use screening and interventions
- Urinary incontinence screening for women yearly
- Well-woman visits to get recommended services for women under 65
- Alcohol, tobacco, and drug use assessments for adolescents
- Autism screening for children at 18 and 24 months
- Behavioral assessments for children ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years
- Bilirubin concentration screening for newborns
- Blood pressure screening for children ages: 0 to 11 months, 1 to 4 years , 5 to 10 years, 11 to 14 years, 15 to 17 years
- Blood screening for newborns
- Cervical dysplasia screening for sexually active females
- Depression screening for adolescents beginning routinely at age 12
- Developmental screening for children under age 3
- Dyslipidemia screening for all children once between 9 and 11 years and once between 17 and 21 years, and for children at higher risk of lipid disorders ages: 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years
- Fluoride chemoprevention supplements for children 6 months through 16 years old without fluoride in their water source
- Fluoride varnish for all infants and children through 6 years old as soon as teeth are present
- Gonorrhea preventive medication for the eyes of all newborns
- Hearing screening for all newborns; and for children once between 11 and 14 years, once between 15 and 17 years, and once between 18 and 21 years
- Height, weight and body mass index (BMI) measurements for children ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years
- Hematocrit or hemoglobin screening for all children
- Hemoglobinopathies or sickle cell screening for newborns
- HIV screening for adolescents at higher risk
- Hypothyroidism screening for newborns
-
Immunization vaccines for children from birth to age 18 — doses, recommended ages, and recommended populations vary:
- Diphtheria, Tetanus, Pertussis (Whooping Cough)
- Haemophilus influenza type b
- Hepatitis A (including all persons aged one year and older experiencing homelessness should be routinely immunized against Hepatitis A, and administered to infants ages 6 to 11 months traveling outside the United States when protection against Hepatitis A is recommended)
- Hepatitis B
- Human Papillomavirus (HPV)
- Inactivated Poliovirus
- Influenza (flu shot)
- Measles
- Meningococcal
- Pneumococcal
- Rotavirus
- Varicella (Chickenpox)
- Iron supplements for children ages 6 to 12 months at risk for anemia
- Lead screening for children at risk of exposure
- Maternal depression screening for mothers of infants at 1, 2, 4, and 6-month visits
- Medical history for all children throughout development ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years
- Obesity screening and counseling
- Oral health risk assessment for young children ages: 0 to 11 months, 1 to 4 years, 5 to 10 years
- Phenylketonuria (PKU) screening for newborns
- Sexually transmitted infection (STI) prevention counseling and screening for adolescents at higher risk
- Skin cancer screening counseling young adults, adolescents, children, and parents of young children about minimizing exposure to UV radiation for persons aged 6 months to 24 years with fair skin types to reduce their risk of skin cancer.
- Tuberculin testing for children at higher risk of tuberculosis ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years
- Vision screening for all children
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