Preventive Health Guidelines for Providers

Size: px
Start display at page:

Download "Preventive Health Guidelines for Providers"

Transcription

1 Preventive Health Guidelines for Providers Sanford Health Plan has adopted the preventive care benefits as outlined under The Patient Protection and Affordable Care Act. Members can refer to their Summary of Plan Benefits for specific Preventive Health coverage. Annual preventive services do not need to be scheduled 12 months apart. Members may have their preventive services one time per calendar year. For example, if the services were done July last year, it is ok to schedule them before July this year. Birth through 3 Years Well Care Visit: Coverage provided for inpatient newborns; visits at 3-5 days old; and at 1, 2, 4, 6, 9, 12, 15, 18, 24 and 30 months old. Visits include: health advice and information about development, behavior, safety/injury prevention, sleep positions, feeding, diet, daily care, physical activity and dental care. During the visit, your child may receive immunizations and screenings based on your healthcare practitioner s recommendations. Preventive Care for Newborns: State/Federal mandated neonatal screening tests Hearing screening One screening between ages 1 18 months. Immunizations: See Childhood Immunization Schedule OR Request printed copy of the immunization schedule Member Services - (605) or NOTE CPT & HCPCS codes for general administration of vaccine include: G0192 As indicated for specific vaccines. ICD-9 Diagnosis V20.0-V20.2, V20.31-V20.32, V70.0, V72.62, V79.3 Influenza: V04.81 CPT Procedure , , HCPCS Procedure G0438, G0439 DTP / DT / Td / DTaP 90698, 90700, 90702, 90703, 90719, 90720, 90721, 90723, Hepatitis A Hepatitis B 90723, 90740, 90744, 90747, 90748, Q3021 Hib 90644, , 90698, 90720, 90721, Influenza 90630, 90654, 90655, 90656, 90657, 90658, 90660, 90661, 90662, 90664, 90672, 90673, 90685, IPV 90698, 90712, 90713, Hepatitis B G0010, Q3021, Q3023 Influenza G0008 Influenza Q2034-Q2039 Revenue

2 MMR , , 90670, Rotavirus 90680, Varicella 90710, G0009 Screenings: Weight, Length and Head Circumference: At every visit. Developmental: In office screening at 9, 18, and 30 months with a V20.2-V20.2, standardized validated tool. V20.31-V20.32, Autism: In office screening at 18 and 24 months with a standardized validated tool. V70.0,V79.3 V20.2-V20.2, V20.31-V20.32, V70.0,V79.3 Vision: In office screen as part of preventive exam which includes alignment/cover test and visual acuity (Snellen) when age appropriate. Hearing: In office assessment as part of preventive exam. Dental: This includes regular oral health screenings and referral to a dentist at the appropriate age. After 6 months of age, your healthcare practitioner may prescribe fluoride if necessary. Hemoglobin Or hematocrit (Hgb/Hct): One Hemoglobin OR One Hematocrit between 9-15 months Cholesterol Test: A baseline Lipid Profile if at high risk, as determined by your healthcare practitioner. Two are allowed between the ages of 0 and 18 years. Lead screenings: One screening test at 12 months and one at 24 months Tuberculosis Screening: As needed if screening questions are positive V20.0-V20.2, V70.0, V70.9, V , V17.3, V17.4, V18.1, V20.0- V20.2, V70.0, V70.9, V72.31-V72.32, V72.62, V72.81, V76.10-V76.19, V76.2, V76.41, V76.44, V V76.51, V77.91, V82.9 V20.2-V20.2, V20.31-V20.32, V70.0,V , 85014, , 82465, 83700, 83701, 83704, 83718, 83719,

3 Ages 4 To 17 Well Care Visit: Once a year for children ages 4 to 17. Visits include: age and gender appropriate health advice and information about dental care, exercise and physical activity, diet and nutrition, counseling for obesity, sun exposure and safety/injury prevention. When appropriate, alcohol, sexual behavior/stds, smoking and suicide prevention is also addressed. During the visit, your child may receive immunizations and screenings based on your healthcare practitioner s recommendation. Immunizations: See Childhood Immunization Schedule OR Request printed copy of the immunization schedule Member Services - (605) or NOTE: HPV series is typically given at ages to both males and females, but may be given from ages NOTE CPT & HCPCS codes for general administration of vaccine include: G0192 As indicated for specific vaccines. ICD-9 Diagnosis V23.49, V70.0, V72.3, V72.31, V72.62, V74.5, V76.10-V76.19, V76.2, V76.41, V76.44, V76.49, V76.50, V79.3 Influenza: V04.81 CPT Procedure , DTP / DT / Td / DTaP / Tdap 90696, 90698, 90700, 90702, 90703, 90714, 90715, 90719, , Hepatitis A Hepatitis B 90723, 90740, 90743, 90744, 90747, Influenza 90630, 90654, 90656, 90658, 90660, 90661, 90662, 90664, 90672, 90673, IPV 90696, 90698, 90712, 90713, Meningococcal MMR , , 90670, HCPCS Procedure G0438, G0439 Hepatitis B G0010, Q3021 Influenza G0008 Influenza Q2034-Q2039 G0009 Revenue Varicella 90710, HPV S0195

4 90649, Screenings: Height/Weight/BMI/Blood Pressure: At every Well Care Visit. At age 6 and over, review of Body Mass Index (BMI), a tool used to screen for obesity, with your healthcare practitioner. Cholesterol Test: A baseline Lipid Profile if at high risk, as determined by your healthcare practitioner. Two are allowed between the ages of 0 and 18 years. Vision: In office screen as part of preventive exam which includes alignment/cover test and visual acuity (Snellen) when age appropriate. Hearing: In office assessment as part of preventive exam. Screening audiograms may be performed at ages 4, 5, 6, 8, and 10 if needed. Dental: This includes regular oral health screenings and referral to a dentist at the appropriate age. After 6 months of age, your healthcare practitioner may prescribe fluoride if necessary. Sexually Transmitted Disease (STD): All sexually active adolescents should be counseled and screened for STDs, including Chlamydia, gonorrhea, syphilis and HIV. Tuberculosis Screening: As needed if screening questions are positive. Screening Depression: Starting at age 12 for major depression , V17.3, V17.4, V18.1, V70.0, V70.9, V V72.32, V72.62, V72.81, V V76.19, V76.2, V77.91, V , 82465, 83700, 83701, 83704, 83718, 83719, In office assessment included as part of the well care visit fee and not billed separately. Audiograms: V72.19, V72.11 Audiograms: Audiograms: V5008 Counseling is included as part of the well care visit fee and not billed separately. V69.2,V70.0, V72.31, V73.88, V73.98, V74.5, V74.9, V75.9, V76.2, V76.47, V02.9, V65.45 V69.2, V70.0, V72.31, V72.62, V73.98, V74.5, V74.9, V75.9, V76.2, V76.47, V69.2 V69.2, V02.9, V70.0, V73.89, V74.5, V75.9, V76.2, V76.47 V70.0,, V72.31, V72.62,V74.5, V65.45, V76.47, V74.9, V76.2, V , 87110, 87270, 87320, , , G0432, G0433, G0435

5 when systems are in place to ensure accurate diagnosis, psychotherapy, & follow up. Ages 18 to 59 Preventive Exam (Physical): Once a year for adults ages Visits include: health advice and counseling about dental care, exercise and physical activity, diet and nutrition, obesity, sun exposure, safety/injury prevention, alcohol, sexual behavior/stds, Medical education and smoking. During the visit, you may receive immunizations and screenings based on your healthcare practitioner s recommendation. Immunizations: See Adult Immunization Schedule OR Request printed copy of the immunization schedule Member Services - (605) or NOTE: HPV series is typically given at ages to both males and females, but may be given from ages NOTE: Pregnant women Tdap is indicated once per pregnancy, in accordance with CDC guidelines. NOTE CPT & HCPCS codes for general administration of vaccine include: G0192 As indicated for specific vaccines. Screenings: For Men & Women Height/Weight/BMI/Blood Pressure: At every Wellness Exam. Review your Body Mass Index (BMI), a tool used to screen for obesity, with your healthcare practitioner. Cholesterol Test: Between the ages 18 and 24 one Lipid Profile ICD-9 Diagnosis V23.49, V70.0, V72.3, V72.31, V72.62, V74.5, V76.10-V76.19, V76.2, V76.41, V76.44, V76.49, V76.50, V79.3 Influenza: V04.81 Shingles age 50+: , V17.3, V17.4, V18.1, V70.0, CPT Procedure , , Hepatitis B 90723, 90740, 90747, 90748, Influenza 90630, 90654, 90656, 90658, 90660, 90661, 90662, 90664, 90672, 90673, Meningococcal , 90670, DTP / DT / Td / DTaP / Tdap 90698, 90703, 90714, 90715, 90719,, 90720, 90721, Varicella 90710, Zostavax Vaccine age 50+: HPV 90649, HCPCS Procedure Hepatitis B G0010, Q3022-Q3023 Influenza G0008 Influenza Q2034-Q2039 G , 82465, 83700, 83701, 83704, 83718, Revenue

6 Between ages 25 and 44 one Lipid Profile every 5 years Age 45 and older one Lipid Profile every year Counseling for Healthy Diet: In office assessment and counseling for members with hyperlipidemia and other known risk factors for cardiovascular disease and diet related chronic disease. Diabetes Screening: Screen for type 2 diabetes in asymptomatic adults with sustained blood pressure (either treated or untreated) greater than 135/80 (fasting blood glucose or basic metabolic panel (see above)). Colorectal Screening: Between ages 40 and 49 - yearly stool for occult blood by fecal hemoglobin Age 50 and older colonoscopy every 10 years or stool for occult blood every year or flexible sigmoidoscopy every 5 years. V70.9, V V72.32, V72.62, V72.81, V V76.19, V76.2, V77.91, V82.9 V70.0, V72.31, V72.62, V77.1 V70.0, V70.9, V72.3, V76.10-V76.19, V76.2, V76.3, 83719, Fasting Blood Glucose: 82947, 82948, , Flexible Sigmoidoscopy: G0328 Flexible Sigmoidoscopy: G0104 RV300-RV319 Colonoscopy: , Colonoscopy: G0105, G0121, G0120 Hemoglobin or hematocrit (Hgb/Hct): One hemoglobin or one hematocrit every year. Sexually Transmitted Disease (STD): For all adults at risk and includes: Chlamydia, gonorrhea, syphilis and HIV. V70.0, V70.9, V76.2, V76.3, V69.2, V70.0, V72.31, V73.88, V73.98, V74.5, V74.9, V75.9, V76.2, V76.47, V02.9, V65.45 V69.2, V70.0, V72.31, V72.62, V73.98, V74.5, V74.9, V75.9, V76.2, V76.47, V69.2 V69.2, V02.9, V70.0, 85013, 85014, , 87110, 87270, 87320, , , G0432, G0433, G0435

7 Depression Screening: Screen for major depression when systems are in place to ensure accurate diagnosis, psychotherapy, and follow up. V73.89, V74.5, V75.9, V76.2, V76.47 V70.0,, V72.31, V72.62,V74.5, V65.45, V76.47, V74.9, V76.2, V For Women Mammogram: One screening per year beginning at age , BRCA Screening: Women with a family history (breast or ovarian cancer) associated with increased risk for harmful mutations in BRCA1 or BRCA2 should be referred for genetic counseling regarding BRCA testing. (Limit 1 per lifetime) Counseling women at high risk for breast cancer: Counseling for chemoprevention of breast cancer (as part of the annual preventive health examination). Pap Smear Age 21 29: Every 3 years. Age 30 65: Every 3 years; or every 5 years if HPV test is also performed. V10.3, V10.43, V16.3, V16.41, V26.33 V70.0, V70.9, V72.31,V72.62, V76.2, V76.47, V76.49 HPV Testing: HPV testing for women over 30 years old , , , , v73.81, V69.2 For Men Prostate Specific Antigen (PSA): one test per year beginning at age 50. Additional Covered Benefits: Basic Metabolic Panel: One per year and should include the following: Calcium, Carbon Dioxide, Chloride, Creatinine, Glucose, Potassium, Sodium, Urea Nitrogen (BUN). V16.42, V70.0, V70.9, V72.62, V76.44, V84.03 V70.0, V70.9, V72.3, V72.31, V72.62, V V76.19, V76.2, G0202, G0204, G0206 RV401, RV S , , 83894, 83903, 83912, 87320, , G0103 G0101, G0123, G0124, G0141, G0143-G0145, G0147, G0148, P3000, P3001, Q0091 RV RV300-RV319

8 Ages 60 + ICD-9 Diagnosis CPT Procedure HCPCS Procedure Revenue Preventive Exam (Physical): Once a year for adults age 60 years +. Visits should include: health advice and counseling about dental care, exercise and physical activity, diet and nutrition, obesity, sun exposure, safety/injury prevention, alcohol, sexual behavior/stds and smoking. During the visit, you may receive immunizations and screenings based on your healthcare practitioner s judgment. Immunizations: See Adult Immunization Schedule OR Request printed copy of the immunization schedule Member Services - (605) or (800) NOTE CPT & HCPCS codes for general administration of vaccine include: G0192 As indicated for specific vaccines. Screenings: For Men & Women Height/Weight/BMI/Blood Pressure: At every Wellness Exam. Review your Body Mass Index (BMI), a tool used to screen for obesity, with your healthcare practitioner. Cholesterol Test: One Lipid Profile per year. V23.49, V70.0, V72.3, V74.5, V76.10-V76.19, V76.2, V76.49, V76.50, V79.3 Influenza: V04.81 Zostavax - age 50+: , V17.3, V17.4, V18.1, V70.0, V70.9, V72.31-V72.32, V72.62, V72.81, V76.10-V76.19, V76.2, V77.91, V , , Hepatitis B 90723, 90740, 90747, 90748, Influenza 90630, , ; Meningococcal , 90670, Td, Tdap Vaccine : 90703, 90714, 90715, Varicella 90710, Zostavax age 50+: Hepatitis B G0010, Q3022-Q3023 Influenza G0008 Influenza Q2034-Q2039 G , 82465, 83700, 83701, 83704, 83718, 83719, 83721

9 Counseling for Healthy Diet: In office assessment and counseling for members with hyperlipidemia and other known risk factors for cardiovascular disease and diet related chronic disease. Diabetes Screening: Screen for type 2 diabetes in asymptomatic adults with sustained blood pressure (either treated or untreated) greater than 135/80 (fasting blood glucose or basic metabolic panel (see above)). Colorectal Screening: One colonoscopy every 10 years or stool for occult blood every year or flexible sigmoidoscopy every 5 years. V70.0, V77.1 V70.0, V70.9, V72.3, V76.10-V76.19, V76.2, V76.3, Fasting Blood Glucose: 82947, 82948, , Flexible Sigmoidoscopy: G0328 Flexible Sigmoidoscopy: G0104 RV300-RV319 Colonoscopy: , Colonoscopy: G0105, G0121, G0120 Hemoglobin Or hematocrit (Hgb/Hct): One Hemoglobin OR One Hematocrit every year. Screening for Depression: Screen for major depression when systems are in place to ensure accurate diagnosis, psychotherapy, and follow up. Sexually Transmitted Disease (STD): For all adults at risk and includes: Chlamydia, gonorrhea, syphilis and HIV. V70.0, V70.9, V72.31, V72.62, V76.2, V76.3, V69.2, V70.0, V72.31, V72.31, V72.62, V73.88, V73.98, V74.5, V74.9, V75.9, V76.2, V76.47, V02.9, V65.45 V69.2, V70.0, V73.98, V74.5, V74.9, V75.9, V76.2, V76.47, V69.2 V69.2, V02.9, V70.0, V73.89, V74.5, V75.9, V76.2, V , 85014, , 87110, 87270, 87320, , , G0432, G0433, G0435

10 For Women Osteoporosis Screening: For women 65 and older or beginning at age 60 if increased risk. (Limit 1 per lifetime) V70.0,V72.31, V72.62,V74.5, V65.45, V76.47, V74.9, V76.2, V02.9 V17.81, V49.81, V70.0, V , 77078, 77080, Mammogram: One screening per year , G0202, G0204, G0206 RV401, RV403 BRCA Screening: Women with a family history (breast or ovarian cancer) associated with increased risk for harmful mutations in BRCA1 or BRCA2 should be referred for genetic counseling regarding BRCA testing. (Limit 1 per lifetime) V10.3, V10.43, V16.3, V16.41, V S0265 Counseling women at high risk for breast cancer: Counseling for chemoprevention of breast cancer (as part of the annual preventive health examination). Pap Smear: Age every 3 years; or every 5 years if HPV test is also performed. For Men Abdominal Aortic Aneurysm Screening: For men ages 65 to 75 years who have ever smoked. (Limit 1 per lifetime) Additional Covered Benefits: Basic Metabolic Panel: One per year and should include the following: Calcium, Carbon Dioxide, Chloride, Creatinine, Glucose, Potassium, Sodium, Urea Nitrogen (BUN). For Men: Prostate Specific Antigen: For men: one test per year V70.0, V70.9, V72.31,V72.62, V76.2, V76.47, V76.49 V15.82, V70.0, V70.8, V72.62, V81.2, V82.89 V70.0, V70.9, V72.3, V76.10-V76.19, V76.2, V16.42, V70.0, V70.9, V72.62, V76.44, V84.03 G , , 76705, 76770, G0101, G0123, G0124, G0141, G0143-G0145, G0147, G0148, P3000, P3001, Q0091 G0389 RV RV300-RV G0103 *Sources: Adopted from Guide to Clinical Preventive Services, 2014: Recommendations of the U.S. Preventive Services Task Force. June Agency for Healthcare Research and Quality, Rockville, MD. CDC, American Cancer Society, Bright Futures at Georgetown University, Sanford Health Plan Physician Quality Committee. Revised: 7/2014

Preventive health guidelines for providers

Preventive health guidelines for providers Preventive health guidelines for providers Sanford Health Plan has adopted the preventive care benefits as outlined under The Patient Protection and Affordable Care Act. Members can refer to their Summary

More information

PREVENTIVE HEALTH GUIDELINES FOR PROVIDERS

PREVENTIVE HEALTH GUIDELINES FOR PROVIDERS PREVENTIVE HEALTH GUIDELINES FOR PROVIDERS Sanford Health Plan has adopted the preventive care benefits as outlined under The Patient Protection and Affordable Care Act. Members can refer to their Summary

More information

Preventive care covered with no cost sharing Get checkups, screenings, vaccines, prenatal care, contraceptives and more with no out-of-pocket costs

Preventive care covered with no cost sharing Get checkups, screenings, vaccines, prenatal care, contraceptives and more with no out-of-pocket costs Quality health plans & benefits Healthier living Financial well-being Intelligent solutions NOTE: Aetna Choice follows the recommendations of the United States Preventive Services Task Force (USPSTF).

More information

2017 Preventive Schedule

2017 Preventive Schedule 2017 Preventive Schedule PLAN YOUR CARE: KNOW WHAT YOU NEED AND WHEN TO GET IT Preventive or routine care helps us stay well or finds problems early, when they are easier to treat. The preventive guidelines

More information

Preventive health guidelines

Preventive health guidelines Preventive health guidelines As of May 2017 What is your plan for better health? Make this year your best year for wellness. Your health plan may help pay for tests to find disease early and routine wellness

More information

Healthcare Reform Preventive Services

Healthcare Reform Preventive Services An Independent Licensee of the Blue Cross and Blue Shield Association The following preventive services and immunizations do not apply to all health plans administered or insured by Blue Cross and Blue

More information

PREVENTIVE HEALTH GUIDELINES

PREVENTIVE HEALTH GUIDELINES PREVENTIVE HEALTH GUIDELINES As of May 2016 What is your plan for better health? Make this year your best year for wellness. Your health plan may help pay for tests to find disease early and routine wellness

More information

Preventive health guidelines As of May 2017

Preventive health guidelines As of May 2017 Preventive health guidelines As of May 2017 What is your plan for better health? Make this year your best year for wellness. Your health plan may help pay for tests to find disease early and routine wellness

More information

kernfamilyhealthcare.com. Si necesita esta información en español, por favor llámenos.

kernfamilyhealthcare.com. Si necesita esta información en español, por favor llámenos. Together in... p revention Preventive Care Gu id e Kern Family Health Care wants you to get good health care. These preventive care guidelines help you stay healthy by preventing diseases or by finding

More information

2017 Preventive Schedule

2017 Preventive Schedule 2017 Preventive Schedule PLAN YOUR CARE: KNOW WHAT YOU NEED AND WHEN TO GET IT Preventive or routine care helps us stay well or finds problems early, when they are easier to treat. The preventive guidelines

More information

Preventive Health Coverage

Preventive Health Coverage Birth to 2 Years Page 1 of 2 Wellness exams and immunizations Well-baby/well-child/well-person exams... Birth, 1, 2, 4, 6, 9, 12, 15, 18, 24 and 30 months Additional visit at 3-5 days after birth and within

More information

Preventive health guidelines

Preventive health guidelines To learn more about your plan, please see www.anthem.com/ca/medi-cal Preventive health guidelines As of May 2016 To learn more about vaccines, please see the Centers for Disease Control and Prevention

More information

Preventive health guidelines As of May 2018

Preventive health guidelines As of May 2018 Preventive health guidelines As of May 2018 What is your plan for better health? Make this year your best year for wellness. Your health plan may help pay for tests and routine wellness exams to find disease

More information

Subject: Preventive Services Policy Effective Date: 08/2017 Revision Date: 05/2018

Subject: Preventive Services Policy Effective Date: 08/2017 Revision Date: 05/2018 Subject: Preventive s Policy Effective Date: 08/2017 Revision Date: 05/2018 DESCRIPTION The Affordable Care Act (ACA) requires nongrandfathered health plans to cover evidence-based preventive care and

More information

Legacy Employee Medical Plan No Cost Preventive Services Listing

Legacy Employee Medical Plan No Cost Preventive Services Listing Important Notes: Patient Protection and Affordable Care Act (PPACA) requires the to provide coverage for the following services at 100 percent only when provided by a Legacy + Network provider. This is

More information

Preventive health guidelines

Preventive health guidelines Preventive health guidelines As of May 2018 What is your plan for better health? Make this year your best year for wellness. Your health plan may help pay for tests to find disease early and routine wellness

More information

SCHEDULE OF BENEFITS PLAN M7

SCHEDULE OF BENEFITS PLAN M7 SCHEDULE OF BENEFITS PLAN M7 Effective September 1, 2017 When you need to see a physician, a physician network, PHCS, is utilized for all physician services (primary care and specialists) and ancillary

More information

Grow & Stay Healthy Guidelines to Live By

Grow & Stay Healthy Guidelines to Live By Grow & Stay Healthy Guidelines to Live By Raising a child can be a lot of work! Trying to remember when to take them to the doctor or which immunizations they need can be a little confusing. Follow the

More information

Preventive health guidelines As of April 2012

Preventive health guidelines As of April 2012 Preventive health guidelines As of April 2012 What is your plan for better health? Make this year your best year for wellness. Your health plan may help pay for tests to find disease early and routine

More information

Blue represents coding updates. G0389 with diagnosis V81.2, V15.82, or with diagnosis V79.1, or

Blue represents coding updates. G0389 with diagnosis V81.2, V15.82, or with diagnosis V79.1, or An Independent Licensee of the Blue Cross and Blue Shield Association Preventive Care Services The following is a list of preventive services (HCP rider) along with the diagnoses and procedure codes that

More information

SCHEDULE OF BENEFITS PLAN C

SCHEDULE OF BENEFITS PLAN C SCHEDULE OF BENEFITS PLAN C Effective September 1, 2016 All benefits, unless otherwise specified, are based on Usual, Customary and Reasonable (UCR) charges, or the network contracted amounts, and are

More information

Preventive care guidelines Blue Cross and Blue Shield of Minnesota

Preventive care guidelines Blue Cross and Blue Shield of Minnesota Service Recommendation Adult men Adult Children Pregnant abdominal aortic aneurysm One-time screening by ultrasound in men aged 65 to 75 who have ever smoked Screening and counseling to reduce alcohol

More information

2018 Preventive Schedule

2018 Preventive Schedule 2018 Preventive Schedule Effective 1/1/2018 PLAN YOUR CARE: KNOW WHAT YOU NEED AND WHEN TO GET IT Preventive or routine care helps us stay well or finds problems early, when they are easier to treat. The

More information

SCHEDULE OF BENEFITS PLAN H1

SCHEDULE OF BENEFITS PLAN H1 SCHEDULE OF BENEFITS PLAN H1 Effective June 1, 2018 This Plan is a High Deductible Health Plan (HDHP), designed to qualify for use with a Health Savings Account (HSA). All charges except charges for preventive

More information

Understanding Preventive Care

Understanding Preventive Care Understanding Preventive Care FAQs: Understanding Preventive Care At Blue Cross and Blue Shield of Vermont, (BCBSVT) we want you to get preventive care so you can find out about health problems early and

More information

Preventive health guidelines As of May 2015

Preventive health guidelines As of May 2015 Preventive health guidelines As of May 2015 What is your plan for better health? Make this year your best year for wellness. Your health plan may help pay for tests to find disease early and routine wellness

More information

Preventive health guidelines

Preventive health guidelines Preventive health guidelines As of May 2016 What is your plan for better health? Make this year your best year for wellness. Your health plan may pay for tests to find disease early and routine wellness

More information

Preventive health guidelines

Preventive health guidelines Preventive health guidelines As of May 2017 What is your plan for better health? Make this year your best year for wellness. Your health plan may help pay for tests to find disease early and routine wellness

More information

Guidelines Description USPSTF HRSA CDC Benefit Description Types Ages

Guidelines Description USPSTF HRSA CDC Benefit Description Types Ages Guidelines Description USPSTF Evidence-based items or services that have a rating of A or B in the current recommendations of the United States Preventive Services Task Force HRSA Evidence-informed exams,

More information

To learn more about your plan, please see empireblue.com.

To learn more about your plan, please see empireblue.com. To learn more about your plan, please see empireblue.com. To learn more about vaccines, please see the Centers for Disease Control and Prevention (CDC) website: cdc.gov. Empire BlueCross and BlueShield

More information

Preventive Care Services Summary

Preventive Care Services Summary Preventive Care Services Summary Below is a list of preventive services along with the diagnoses and procedure codes that Community Health Options has determined to meet or exceed the requirements and

More information

Preventive Care Services Summary

Preventive Care Services Summary Preventive Care Services Summary Below is a list of preventive services along with the diagnoses and procedure codes that Community Health Options has determined to meet or exceed the requirements and

More information

2019 Preventive Schedule Effective 1/1/2019

2019 Preventive Schedule Effective 1/1/2019 2019 Preventive Schedule Effective 1/1/2019 PLAN YOUR CARE: KNOW WHAT YOU NEED AND WHEN TO GET IT Preventive or routine care helps us stay well or finds problems early, when they are easier to treat. The

More information

2019 Preventive Schedule Effective 1/1/2019

2019 Preventive Schedule Effective 1/1/2019 2019 Preventive Schedule Effective 1/1/2019 PLAN YOUR CARE: KNOW WHAT YOU NEED AND WHEN TO GET IT Preventive or routine care helps us stay well or finds problems early, when they are easier to treat. The

More information

Statement of Coverage. Preventive Health Services Policy. Policy Specific Section: Preventive Health Guidelines

Statement of Coverage. Preventive Health Services Policy. Policy Specific Section: Preventive Health Guidelines Statement of Coverage Preventive Health Services Policy Type: Preventive Health Guidelines Policy Specific Section: Medicine Group Plans Effective Date: September 23, 2010 * or upon renewal * Effective

More information

Preventive health guidelines As of May 2014

Preventive health guidelines As of May 2014 To learn more about your plan, please see anthem.com/ca. To learn more about vaccines, please see the Centers for Disease Control and Prevention (CDC) website: cdc.gov. Preventive health guidelines As

More information

Indemnity PPO Medical Plan Preventive Care Guidelines 2019

Indemnity PPO Medical Plan Preventive Care Guidelines 2019 Indemnity PPO Medical Plan Preventive Care Guidelines 2019 The District Council 16 Northern California Health and Welfare Trust Fund Medical Plan offers 100% coverage for many routine preventive care services

More information

To learn more about your plan, please see anthem.com/ca.

To learn more about your plan, please see anthem.com/ca. To learn more about your plan, please see anthem.com/ca. To learn more about vaccines, please see the Centers for Disease Control and Prevention (CDC) website: cdc.gov. Anthem Blue Cross is a health plan

More information

2016 Preventive Health Care Guidelines. Free preventive care to help you be your healthiest.

2016 Preventive Health Care Guidelines. Free preventive care to help you be your healthiest. 2016 Preventive Health Care Guidelines Free preventive care to help you be your healthiest. We want to help you be your healthiest. That s why we recommend over 30 free preventive care services for kids,

More information

Preventive care guidelines for children and adults.

Preventive care guidelines for children and adults. Preventive care guidelines for children and adults. Keeping a focus on regular preventive care can help you and your family stay healthy. Preventive care can help you avoid potentially serious health conditions

More information

HorizonBlue.com. We ve got you covered. Preventive care at no cost to you.

HorizonBlue.com. We ve got you covered. Preventive care at no cost to you. HorizonBlue.com We ve got you covered. Preventive care at no cost to you. Did you know that Horizon Blue Cross Blue Shield of New Jersey provides full coverage for certain preventive services at no cost

More information

2018 Preventive Schedule

2018 Preventive Schedule 2018 Preventive Schedule Effective 1/1/2018 PLAN YOUR CARE: KNOW WHAT YOU NEED AND WHEN TO GET IT Preventive or routine care helps us stay well or finds problems early, when they are easier to treat. The

More information

Indemnity PPO Medical Plan Preventive Care Guidelines

Indemnity PPO Medical Plan Preventive Care Guidelines Indemnity PPO Medical Plan Preventive Care Guidelines The Indemnity PPO Medical Plan offers 100% coverage for many routine preventive care services for you and your covered dependents when care is received

More information

Prevents future health problems. You receive these services without having any specific symptoms.

Prevents future health problems. You receive these services without having any specific symptoms. PREVENTIVE CARE To help you live the healthiest life possible, we offer free preventive services for most Network Health members. Please refer to your member materials, which you received when you enrolled

More information

2017 Preventive Health Care Guidelines

2017 Preventive Health Care Guidelines 2017 Preventive Health Care Guidelines NEXT All Adults 4 Women 6 Pregnant Women 8 Children 10 Guidelines may change throughout the year based on new research and recommendations. Get the most up-to-date

More information

2019 Preventive Schedule Effective 1/1/2019

2019 Preventive Schedule Effective 1/1/2019 2019 Preventive Schedule Effective 1/1/2019 PLAN YOUR CARE: KNOW WHAT YOU NEED AND WHEN TO GET IT Preventive or routine care helps us stay well or finds problems early, when they are easier to treat. The

More information

Preventive Services at 100%

Preventive Services at 100% September 1, 2014 Update Preventive Care Services Covered Without Cost-sharing Without Copay, Coinsurance or Deductible The Affordable Care Act (ACA) requires non-grandfathered health plans and policies

More information

GUYS, THIS IS YOUR WELLNESS CHECKLIST Use it to stay up to date and in the know about your health.

GUYS, THIS IS YOUR WELLNESS CHECKLIST Use it to stay up to date and in the know about your health. GUYS, THIS IS YOUR WELLNESS CHECKLIST Use it to stay up to date and in the know about your health. The top six things you can do to live a healthier life: Get recommended tests. Be tobacco-free. Be physically

More information

Under the Affordable Care Act (ACA), private insurers except for plans that have been

Under the Affordable Care Act (ACA), private insurers except for plans that have been Brought to you by the insurance professionals at HUB International Preventive Care Once an underused component of the health care world that benefits both employees health and employers health care spending,

More information

2019 Preventive Schedule

2019 Preventive Schedule State System of Higher Education 2019 Preventive Schedule Effective 1/1/2019 PLAN YOUR CARE: KNOW WHAT YOU NEED AND WHEN TO GET IT Preventive or routine care helps us stay well or finds problems early,

More information

2017 Preventive Health Care Guidelines Free preventive care to help you be your healthiest.

2017 Preventive Health Care Guidelines Free preventive care to help you be your healthiest. 2017 Preventive Health Care Guidelines Free preventive care to help you be your healthiest. Guidelines may change throughout the year based on new research and recommendations. Get the most up-to-date

More information

2018 Preventive Schedule Effective 1/1/2018

2018 Preventive Schedule Effective 1/1/2018 2018 Preventive Schedule Effective 1/1/2018 PLAN YOUR CARE: KNOW WHAT YOU NEED AND WHEN TO GET IT Preventive or routine care helps us stay well or finds problems early, when they are easier to treat. The

More information

EmblemHealth Preventive Care/Screening Services Exempt from Cost-Share

EmblemHealth Preventive Care/Screening Services Exempt from Cost-Share EmblemHealth Preventive Care/Screening Services Exempt from Cost-Share The Affordable Care Act (ACA) requires non-grandfathered health plans in the individual and group markets to cover certain preventive/screening

More information

2014 Preventive Health Care Guidelines. Grandfathered plans. We want to help you be your

2014 Preventive Health Care Guidelines. Grandfathered plans. We want to help you be your 2014 Preventive Health Care Guidelines We want to help you be your Grandfathered plans and women. healthiest because when you re healthy, you can live life to the fullest. That s why we recommend over

More information

SCHEDULE OF BENEFITS PLAN M7

SCHEDULE OF BENEFITS PLAN M7 SCHEDULE OF BENEFITS PLAN M7 Effective September 1, 2016 All benefits, unless otherwise specified, are based on Usual, Customary and Reasonable (UCR) charges, or the network contracted amounts, and are

More information

2017 Preventive Health Care Guidelines Free preventive care to help you be your healthiest.

2017 Preventive Health Care Guidelines Free preventive care to help you be your healthiest. 2017 Preventive Health Care Guidelines Free preventive care to help you be your healthiest. Guidelines may change throughout the year based on new research and recommendations. Get the most up-to-date

More information

DETAILED 2014 PREVENTIVE CARE SERVICES

DETAILED 2014 PREVENTIVE CARE SERVICES DETAILED 2014 PREVENTIVE CARE SERVICES How often and what kind of preventive care services you need depends upon your age, gender, health and family history. Your provider determines whether services delivered

More information

ACA first-dollar coverage for preventive services

ACA first-dollar coverage for preventive services I N F O R M A T I O N U P D A T E September 2014 ACA first-dollar coverage for preventive services The Affordable Care Act (ACA) mandates that all non-grandfathered group and individual health plans must

More information

Coverage for preventive care

Coverage for preventive care Coverage for preventive care Understanding your preventive care coverage Preventive care, like screenings and immunizations, helps you and your family stay healthier and can help lower your overall out-of-pocket

More information

Preventive Care Services

Preventive Care Services Preventive Care Services Preventive Care Services What are preventive care services? It s important to visit your doctor regularly to get preventive care. Preventive care lets your doctor find potential

More information

Preventive Services Reference Guide for Members 2018

Preventive Services Reference Guide for Members 2018 Preventive Services Reference Guide for Members 2018 Together with Children s Community Health Plan (CCHP) covers many preventive services at no cost to you, including screening tests and immunizations

More information

2017 Employer Update Covering Preventive Services

2017 Employer Update Covering Preventive Services 2017 Employer Update Covering Preventive Services Preventive Care Services Covered With No Cost to the Member Your group health plan covers certain preventive services as a benefit of membership, at no

More information

Preventive health guidelines

Preventive health guidelines Preventive health guidelines As of May 2017 What is your plan for better health? Make this year your best year for wellness. Your health plan may help pay for tests to find disease early and routine wellness

More information

Preventive Care Coverage

Preventive Care Coverage Preventive Care Coverage Benefits designed to protect your health BridgeSpanHealth.com Review Coverage» To find out if you re eligible for preventive coverage, call the Member Services number on the back

More information

Preventive health guidelines

Preventive health guidelines Preventive health guidelines As of May 2017 What is your plan for better health? Make this year your best year for wellness. Your health plan may help pay for tests to find disease early and routine wellness

More information

Preventive health guidelines As of May 2016

Preventive health guidelines As of May 2016 Preventive health guidelines As of May 2016 What is your plan for better health? Make this year your best year for wellness. Your health plan may help pay for tests to find disease early and routine wellness

More information

2018 Preventive Schedule Effective 1/1/2018

2018 Preventive Schedule Effective 1/1/2018 2018 Preventive Schedule Effective 1/1/2018 PLAN YOUR CARE: KNOW WHAT YOU NEED AND WHEN TO GET IT Preventive or routine care helps us stay well or finds problems early, when they are easier to treat. The

More information

Ages 19 to 49: Every 1 to 2 years Ages 50 and older: Once a year Once a year. High-risk. High-risk. High-risk

Ages 19 to 49: Every 1 to 2 years Ages 50 and older: Once a year Once a year. High-risk. High-risk. High-risk State System of Higher Education 2018 Preventive Schedule PLAN YOUR CARE: KNOW WHAT YOU NEED AND WHEN TO GET IT Preventive or routine care helps us stay well or finds problems early, when they are easier

More information

GUYS, THIS IS YOUR WELLNESS CHECKLIST Use it to stay up to date and in the know about your health.

GUYS, THIS IS YOUR WELLNESS CHECKLIST Use it to stay up to date and in the know about your health. GUYS, THIS IS YOUR WELLNESS CHECKLIST Use it to stay up to date and in the know about your health. The top six things you can do to live a healthier life: Get recommended screening tests. Be tobacco-free.

More information

Preventive health guidelines

Preventive health guidelines Preventive health guidelines As of May 2016 What is your plan for better health? Make this year your best year for wellness. Your health plan may pay for tests to find disease early and routine wellness

More information

Preventive health guidelines

Preventive health guidelines Preventive health guidelines As of May 201 ww What is your plan for better health? Make this year your best year for wellness. Your health plan may help pay for tests to find disease early and routine

More information

retiree reinsurance prog

retiree reinsurance prog Preventive coverage Kaiser Foundation Health Plan of the Northwest has always offered broad, affordable coverage options that encourage members to seek care before a health condition becomes serious. And

More information

Preventive care services for commercial members

Preventive care services for commercial members Preventive care services for commercial members This schedule is a reference tool for planning your preventive care, and lists items/services covered under the Patient Protection and Affordable Care Act

More information

2017 Preventive Schedule

2017 Preventive Schedule 2017 Preventive Schedule PLAN YOUR CARE: KNOW WHAT YOU NEED AND WHEN TO GET IT Preventive or routine care helps us stay well or finds problems early, when they are easier to treat. The preventive guidelines

More information

Services. Colorado RegionEALTH CARE REFORM UPDATE

Services. Colorado RegionEALTH CARE REFORM UPDATE Health Care Reform Preventive Hpreventive Services Services Colorado Region Colorado RegionEALTH CARE REFORM UPDATE Your guide to preventive services for the Preventive services coverage for over 65 years,

More information

2018 Preventive Schedule Effective 1/1/2018

2018 Preventive Schedule Effective 1/1/2018 2018 Preventive Schedule Effective 1/1/2018 PLAN YOUR CARE: KNOW WHAT YOU NEED AND WHEN TO GET IT Preventive or routine care helps us stay well or finds problems early, when they are easier to treat. The

More information

Preventive Health Care Guidelines. Free preventive care to help you be your healthiest.

Preventive Health Care Guidelines. Free preventive care to help you be your healthiest. 2016-2017 Preventive Health Care Guidelines Free preventive care to help you be your healthiest. Priority Health is committed to improving the health and lives of you and your family. That s why we give

More information

Preventive Health Guidelines

Preventive Health Guidelines Preventive Health Guidelines As of September 2009 What is your plan for better health? Make this year your best year for overall wellness. Your health benefits plan may cover early detection screenings

More information

Your guide to preventive retiree reinsurance prog

Your guide to preventive retiree reinsurance prog Preventive coverage Kaiser Permanente has always offered broad, affordable coverage options that encourage members to seek care before a health condition becomes serious. And we remain committed to improving

More information

PREVENTIVE HEALTHCARE GUIDELINES INTRODUCTION

PREVENTIVE HEALTHCARE GUIDELINES INTRODUCTION PREVENTIVE HEALTHCARE GUIDELINES INTRODUCTION Health Plan of Nevada and Sierra Health and Life suggest that health plan members get certain screening tests, exams and shots to stay healthy. This document

More information

Headline. Preventive care covered with no cost sharing

Headline. Preventive care covered with no cost sharing Headline Preventive care covered with no cost sharing Get checkups, screenings, vaccines, prenatal care, contraceptives and more with no out-of-pocket costs 00.03.537.1 H (10/17) aetna.com Good news your

More information

PREVENTION CARE IN ADULTS

PREVENTION CARE IN ADULTS PREVENTION CARE IN ADULTS Hong Xiao, M.D. Department of Family & Community Medicine Weight and BMI Abdominal Aortic Aneurysm (AAA) Blood Pressure Breast Exam Breast Cancer Mammogram Breast Cancer BRCA

More information

Wellness Preventive Health Guide

Wellness Preventive Health Guide Wellness Preventive Health Guide Protect Your Health with Good Preventive Care Plan Now for Better Health One of the best ways to maintain good health and lower the risk of future health concerns for you

More information

UFCW LOCAL 1500 WELFARE FUND PREVENTIVE CARE SERVICE BENEFITS REVISED AS OF JANUARY 1, 2015

UFCW LOCAL 1500 WELFARE FUND PREVENTIVE CARE SERVICE BENEFITS REVISED AS OF JANUARY 1, 2015 UFCW LOCAL 1500 WELFARE FUND PREVENTIVE CARE SERVICE BENEFITS REVISED AS OF JANUARY 1, 2015 PREVENTIVE SERVICES Preventive Services Benefit Overview The UFCW Local 1500 Welfare Fund provides coverage for

More information

2018 Preventive Schedule Effective 1/1/2018

2018 Preventive Schedule Effective 1/1/2018 2018 Preventive Schedule Effective 1/1/2018 PLAN YOUR CARE: KNOW WHAT YOU NEED AND WHEN TO GET IT Preventive or routine care helps us stay well or finds problems early, when they are easier to treat. The

More information

Preventive Care Coverage

Preventive Care Coverage STAYING WELL Preventive Care Coverage Regence BlueCross BlueShield of Oregon is an Independent Licensee of the Blue Cross and Blue Shield Association Wondering what preventive care your plan covers? Our

More information

World Bank Group Medical Benefits Plan (MBP) A Guide to Preventive Care Effective 2015

World Bank Group Medical Benefits Plan (MBP) A Guide to Preventive Care Effective 2015 World Bank Group Medical Benefits Plan (MBP) A Guide to Preventive Care Effective The Bank Group s Medical Benefits Plan (MBP), Continuation Medical Benefits Plan (CMBP) and Retiree Medical Benefits Plan

More information

PEDIATRIC - INFANCY PREVENTIVE HEALTH CARE GUIDELINES

PEDIATRIC - INFANCY PREVENTIVE HEALTH CARE GUIDELINES PEDIATRIC - INFANCY AGE SCREENING ASSESSMENT/EDUCATION RISK ASSESSMENT IMMUNIZATIONS (if indicated) Newborn Length/Height and Weight Physical Examination/Unclothed Hep B #1 Blood Pressure Head Circumference

More information

Take advantage of preventive care to help manage your health

Take advantage of preventive care to help manage your health Take advantage of preventive care to help manage your health Preventing disease and detecting health issues at an early stage, if they occur, are important to living a healthy life. Following the recommended

More information

Take advantage of preventive care to help manage your health

Take advantage of preventive care to help manage your health Take advantage of preventive care to help manage your health Preventing disease and detecting health issues at an early stage, if they occur, are important to living a healthy life. Following the recommended

More information

Prenatal-Postpartum Care Guidelines, Paramount

Prenatal-Postpartum Care Guidelines, Paramount Prenatal-Postpartum Care Guidelines, Paramount Initial Evaluation Height Weight current and prepregnancy Physical examination Ultrasound (body mass index) Cell-free DNA (if older than age 35 or at risk)

More information

Preventive Care Guide

Preventive Care Guide Preventive Care Guide Kern Family Health Care wants you to get good health care. These preventive care guidelines help you stay healthy by preventing diseases or by finding them early on. Preventive care

More information

PEDIATRIC - INFANCY PREVENTIVE HEALTH CARE GUIDELINES

PEDIATRIC - INFANCY PREVENTIVE HEALTH CARE GUIDELINES PEDIATRIC - INFANCY AGE SCREENING ASSESSMENT/EDUCATION RISK ASSESSMENT IMMUNIZATIONS (if indicated) Newborn Length/Height and Weight Physical Examination/Unclothed Hep B #1 Blood Pressure Head Circumference

More information

Preventive health guidelines

Preventive health guidelines Preventive health guidelines As of May 2017 What is your plan for better health? Make this year your best year for wellness. Your health plan may help pay for tests to find disease early and routine wellness

More information