Covered at 100 innetwork not subject to deductible Cancer Screenings Breast Cancer Mammography Cervical Cancer Laboratory Testing Colon Cancer Colonoscopy Sigmoidoscopy and associated laboratory tests eg biopsy ID: 753971
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Preventive Screenings at no cost to you
Covered at 100% in-network, not subject to deductible
Cancer ScreeningsBreast Cancer: MammographyCervical Cancer: Laboratory TestingColon Cancer: Colonoscopy, Sigmoidoscopy and associated laboratory tests, e.g. biopsyProstate Cancer: Digital Rectal Exam and Antigen (PSA) testBreast Cancer Susceptibility Gene (BRCA) CounselingBreast Cancer Susceptibility Gene (BRCA) Genetic Testing, when medically appropriate (1/1/14)
Annual Adult Physicals and
Routine Gynecological CarePhysical ExaminationsRoutine Gynecologic ExaminationsPrimary Preventive Counseling Electrocardiogram Obesity ScreeningOsteoporosis Screening Abdominal Aortic Aneurysm Screening
Pediatric Prevention through age 21
Well Child Care visitsScreening tests - Newborn Hearing - Annual vision - Developmental Screening (condition restrictions apply) - Major Depressive Disorder Screening
Blood/urine and other laboratory tests to screen for the following:
Rh IncompatibilityLipid Disorder – Cholesterol, lipoprotein, and triglyceridesBacteruria (For pregnant women only)Chlamydial InfectionGonorrheaHIVSyphilis InfectionHPV Detection Diabetes Type IIIron Deficiency Anemia Sickle Cell Disease Lead
Immunizations and tobacco
cessationInfluenza (i.e. H1N1)DTaP (Diphtheria, tetanus, pertussis)Hepatitis AHepatitis BHib (Haemophilus Influenzae Type b)Human Papilloma-virus (HPV)Meningococcal Conjugate (MCV) or Polysaccharide (MPSV)MMR (Measles, mumps and rubella)Pneumococcal polysaccharide (PPSV) PolioRotavirus (RV)TetanusVaricella (Chickenpox)Zoster (Shingles)Counseling for Tobacco Use and prescribed generic (including OTC) tobacco Cessation products for adults. Chantix Included.
Women’s Preventive Care
FDA approved contraception devices – including Insertion/removalContraception – Sterilization proceduresPrescribed FDA approved generic contraceptives (including OTC) and contraceptive counseling (1/1/14) Does not include abortifacient drugs. Breast feeding supplies (breast pump), support and lactation counselingPrenatal care office visits
Age, gender, condition
and medical
necessity
restrictions may apply.
See
benefit
administrator for
details