2017 Employer Update Covering Preventive Services

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1 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 cost to the member when they use a provider in your plan s network. There is no copay, deductible or coinsurance, even if the individual or family deductible or out-of-pocket maximum has not been met. Covered Preventive Care Services1 Depending on the particular health plan, coverage may be provided for the preventive services listed in this guide, at no cost to the member when seeing a provider participating in a health plan s provider network. This list may not include all of a particular plan s covered preventive services. Blue Cross and Blue Shield of Illinois members can call Customer Service at the number on their member ID card for details on how these benefits apply to their coverage and for the most up-to-date list of covered preventive services, including those paid without any cost-sharing.

2 2017 Employer Update Covering Preventive Services Children and Adolescents Children and Adolescents Well-child exam Examples of services included as part of an annual well-child exam include history and physical exam, and measurements of height, weight and body mass index (BMI). Immunizations Diphtheria, Tetanus, Pertussis Whooping Cough Haemophilus Influenzae Type B Hepatitis A Hepatitis B Human Papillomavirus (HPV) Influenza (Flu) Measles, Mumps, Rubella Meningococcal Pneumococcal Inactivated Poliovirus Rotavirus Varicella (Chickenpox) Learn more on recommendations of children and adolescents immunization schedule: Screening Tests and Counseling Alcohol and drug use assessment for adolescents Autism Cervical dysplasia screening Depression screening Dyslipidemia screening (for children at higher risk) Hematocrit or hemoglobin screening HIV screening Lead screening Obesity screening and counseling Screening for hearing loss, hypothyroidism, sickle cell disease and phenylketonuria (PKU) in newborns Screening for sexually transmitted infections (STIs) Skin cancer behavioral counseling for young adults Tuberculin testing Visual acuity screening Preventive Treatments Dental caries prevention fluoride varnish and oral fluoride supplementation Gonorrhea preventive medication for eyes of all newborns

3 2017 Employer Update Covering Preventive Services Adults Adults Preventive exam Examples of services included as part of an annual preventive exam include history and physical exam, measurements of height, weight and body mass index (BMI). Hepatitis A Hepatitis B Haemophilus Influenzae Type B (Hib) Human Papillomavirus (HPV) Influenza (Flu) Measles, Mumps, Rubella Meningococcal Pneumococcal Tetanus, Diphtheria, Pertussis Varicella (Chickenpox) Zoster Immunizations Learn more on recommendations of adults immunization schedule: Screening Tests Abdominal aortic aneurysm screening Blood pressure screening Cholesterol screening Colorectal cancer screening Depression screening Diabetes screening for adults with high blood pressure Hepatitis B screening Hepatitis C screening HIV screening and counseling Lung cancer screening Obesity screening Sexually transmitted infection (STI) screenings (chlamydia, gonorrhea, syphilis) Health Counseling Alcohol misuse screening and counseling Falls prevention vitamin D supplementation Healthy diet and physical activity counseling for adults who are overweight or obese and have additional cardiovascular risk disease factors Obesity counseling Prevention of sexually transmitted infections (STIs) Sexually transmitted infections counseling Skin cancer behavioral counseling for young adults Tobacco use cessation (Includes prescription for one or more products within the categories approved by the FDA for use in smoking cessation) Use of aspirin to prevent cardiovascular disease

4 2017 Employer Update Covering Preventive Services Women Only Annual well woman visit Breast cancer prevention medication Breast cancer screening mammography Cervical cancer screening including pap smear Counseling related to chemoprevention of breast cancer Genetic counseling and evaluation for BRCA testing where family history is associated with an increased risk Human papillomavirus (HPV) DNA test Intimate partner violence counseling and screening Osteoporosis screening Contraception 2 The following contraceptive items and services are covered without cost-sharing when provided by a health care provider in a health plan s network. One or more prescribed products within each of the categories approved by the FDA for use as a method of contraception FDA approved contraceptives available over the counter (foam, sponge, female condoms), when prescribed by a physician The morning after pill Medical devices such as IUD, diaphragm, cervical cap and contraceptive implants Female sterilization, including tubal ligation Specifically for Pregnant Women Alcohol misuse screening and counseling Anemia screening Aspirin for preeclampsia prevention Bacteriuria screening Breastfeeding support, supplies and counseling Folic acid supplementation Gestational diabetes screening Hepatitis B screening HIV screening Rh(D) incompatibility screening Screenings for sexually transmitted infections (STIs) including chlamydia, gonorrhea, and syphilis Tobacco use and cessation counseling 1 Non-grandfathered health plans are required by the Affordable Care Act to provide coverage for preventive care services without cost-sharing only when the member uses a network provider. This includes preventive care services as follows: Evidence-based items/services rated A or B in the current recommendations of the U.S. Preventive Services Task Force Routine immunizations for children, adolescents and adults recommended by the Advisory Committee on Immunization Practices of the Centers for Disease control and prevention Evidence-informed preventive care and screenings for infants, children, and adolescents in the comprehensive guidelines of the Health Resources and Services Administrations Evidence-based preventive care and screenings for women described in the comprehensive guidelines of the Health Resources and Services Administration 2 Certain group health plans established or maintained by organizations that qualify as religious employers may be exempt. These services may be covered under a plan s Pharmacy benefits. The fact that a particular medical service is listed in this document is not a guarantee that benefits are available for such service. The member is instructed to refer to their health benefits document to determine what benefits are available for the particular medical service. Blue Cross and Blue Shield of Illinois, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association

5 2017 Adult Wellness Guidelines Making Preventive Care a Priority Adult Health - for ages 18 and over Preventive care is very important for adults. By making some good basic health choices, women and men can boost their own health and well being. Some of these positive choices include: Eat a healthy diet Get regular exercise Don t use tobacco Limit alcohol use Strive for a healthy weight Weight Body Mass Index (BMI) Blood Pressure (BP) Colon Cancer Screening Diabetes Screening Screenings Every 1 to 3 Every 1 to 3 At least every 2 * Adults ages 50 to 75 colonoscopy every 10, OR flexible sigmoidoscopy every 5 OR fecal occult blood test annually* Those with high blood pressure should be screened. Others, especially those who are overweight or have additional risk factors, should consider screening every 3.* Hepatitis C (HCV) Screening Once for adults born between 1945 and 1965 HIV Screening Tetanus Diphtheria Pertussis (Td/Tdap) Influenza (Flu) Immunizations (Vaccines) Adults ages 18 to 65, older adults at increased risk and all pregnant women should be screened Get Tdap vaccine once, then a Td booster every 10 Yearly * Recommendations may vary. Discuss the start and frequency of screenings with your doctor, especially if you are at increased risk. Herpes Zoster (Shingles) Varicella (Chicken Pox) Pneumococcal (Pneumonia) Measles, Mumps, Rubella (MMR) Human Papillomavirus (HPV) Ages 60 and over 2 doses if no evidence of immunity Ages 65 and over* 1 or 2 doses for adults born in 1957 or later who have no evidence of immunity 3 doses for women ages 18 to 26 if not already given 3 doses for men ages 18 to 21 if not already given*

6 Women s Health Women have their own unique health care needs. To stay well, women should make regular screenings a priority. In addition to the services listed in the Adult Health section, women should also discuss the recommendations listed on the chart to the right with their doctor. Mammogram Clinical Breast Exam Cholesterol Women s Recommendations At least every 2 for women ages 50 to 74 Ages 40 to 49 should discuss the risks and benefits of screening with their doctor Every 3 for women ages 20 to 39 Annually for age 40 and over Starting age and frequency of screenings are based on your individual risk factors. Talk with your doctor about what is best for you. Men s Health Men are encouraged to get care as needed and make smart choices. That includes following a healthy lifestyle and getting recommended preventive care services. If men follow a game plan for better overall health, they ll be more likely to win at wellness. Cervical Cancer Screening Osteoporosis Screening Aspirin Use Women ages 21 to 65: Pap test every 3 Another option for ages 30 to 65: Pap test and HPV test every 5 Women who have had a hysterectomy or are over age 65 may not need a Pap test* Beginning at age 65, or at age 60 if risk factors are present* Talk with your doctor about the benefits and risks of aspirin use. In addition to the services listed in the Adult Health section, men should also discuss the recommendations shown in the chart to the right with their doctor. Learn more! Additional sources of health information include: ahrq.gov/patients-consumers/prevention/index.html cancer.org/healthy/index cdc.gov/healthyliving/ Cholesterol Prostate Cancer Screening Abdominal Aortic Aneurysm Aspirin Use Men s Recommendations Starting age and frequency of screenings are based on your individual risk factors. Talk with your doctor about what is best for you. Discuss the benefits and risks of screening with your doctor.* Have an ultrasound once between ages 65 to 75 if you have ever smoked. Talk with your doctor about the benefits and risks of aspirin use. You probably don t hesitate to ask your doctor about nutrition and exercise, losing weight and stopping smoking. These may include: Dental health Problems with drugs or alcohol Sexual behavior and sexually transmitted diseases Feelings of depression Domestic violence Accident/injury prevention Preventing falls, especially for ages 65 and over * Recommendations may vary. Discuss screening options with your doctor, especially if you are at increased risk. The recommendations provided in the table are based on information from organizations such as the Advisory Committee on Immunization Practices, the American Academy of Family Physicians, the American Cancer Society and the United States Preventive Services Task Force. The recommendations are not intended as medical advice nor meant to be a substitute for the individual medical judgment of a doctor or other health care professional. Please check with your doctor for individualized advice on the recommendations provided. Coverage for preventive care services at no cost share may vary depending on your specific benefit plan and use of network providers. For questions, please call the Customer Service number on the back of your ID card. Blue Cross and Blue Shield of Illinois, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association

7 2017 Good health is a gift anyone would wish for a child, but it doesn t happen without your help. Some things you can do to help keep your child well: Introduce good nutrition at an early age and be a good role model Encourage lots of play and physical activity Keep up with recommended vaccinations Blue Cross and Blue Shield of Illinois (BCBSIL) wants your child to be well. Children s Wellness Guidelines Laying the Groundwork for a Healthy Tomorrow Children s Health Put your child on the path to wellness right away by scheduling preventive care visits with a doctor. The doctor will watch your child s growth and progress and should talk with you about eating and sleeping habits, safety and behavior issues. According to the Bright Futures recommendations from the American Academy of Pediatrics, the doctor should: Check your child s Body Mass Index percentile regularly beginning at age 2 Check blood pressure yearly, beginning at age 3 Screen hearing at birth, then yearly from ages 4 to 6, then at ages 8 and 10 Test vision yearly from ages 3 to 6, then at ages 8, 10, 12, 15 and 18 Help protect your child from sickness. Make sure they get the recommended vaccinations shown in the charts. If your child has missed vaccinations, ask your doctor how to catch up. Learn more! An additional source of health information is available at healthychildren.org Please note: These Recommendations are for healthy children who don t have any special health risks. Take time to check the following summaries of key preventive services.

8 Be sure your child is up-to-date on immunizations and health screenings. Routine Children s Immunization Schedule 1 Vaccine Birth 1 month / Hepatitis B (HepB) Rotavirus (RV) Diphtheria Tetanus and Pertussis (DTaP) Haemophilus Influenzae Type B (Hib) Pneumococcal Conjugate (PCV) Inactivated Polio Vaccine (IPV) Influenza (Flu) Measles, Mumps and Rubella (MMR) Recommended yearly starting at age 6 with 2 doses given the first year Varicella (Chicken pox) Hepatitis A (HepA) First dose: 12 to 23 Second dose: 6 to 18 later Tweens and Teenagers As your children grow into teens, they should continue yearly preventive care visits for exams and scheduled immunizations. These visits give the doctor a chance to: One dose Shaded areas indicate the vaccine can be given during shown age range. Discuss the importance of good eating habits and regular physical activity Talk about avoiding alcohol, smoking and drugs Screen for sexual activity and sexually transmitted diseases as appropriate. Screen for HIV between the ages of 16 and 18. Recommended Immunizations for ages 7 to 18 1 Vaccine Tetanus Diphtheria Pertussis (Tdap) Human Papillomavirus (HPV) - females and males 3 doses Meningococcal (MCV) Influenza (Flu) Yearly 1. These recommendations come from the Centers for Disease Control and Prevention and the American Academy of Pediatrics (cdc.gov/vaccines/hcp/acip-recs/index.html). The recommendations are not intended as medical advice nor meant to be a substitute for the individual medical judgment of a doctor or other health care professional. Please check with your doctor for individual advice on the recommendations provided. Coverage for preventive services may vary depending on your specific benefit plan and use of network providers. For questions, please call the Customer Service number on the back of your ID card. Blue Cross and Blue Shield of Illinois, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association

9 2017 Perinatal Wellness Guidelines Routine recommendations for a healthy pregnancy Before Pregnancy It s important to start making better choices and maintaining a healthy weight and a healthy lifestyle. Visit your doctor for a checkup before becoming pregnant. First Prenatal Visit Your doctor will evaluate your personal health and family history. This helps your doctor plan the best care for you and your new baby. The first visit is usually the longest, so be prepared. You may be asked about: The date of your last menstrual period to help predict when your baby will be born Health problems like diabetes, high blood pressure or sexually transmitted disease Past pregnancies and any complications Previous hospital admissions Current medicines and vaccination history Allergies to medicines, foods, etc. Whether you drink alcohol, use tobacco or drugs such as marijuana or ecstasy Your diet and eating habits and how much you exercise Stress in your life How safe you feel in your current living arrangements Health history of the baby s father Family history Your doctor will also examine you, do some tests and offer advice. The doctor may: Check your height, weight and blood pressure Perform a physical exam, including a pelvic exam Take a urine sample for analysis Take blood to test for anemia and certain infections Prescribe prenatal vitamins Give vaccinations, if necessary Provide education about what to expect during your pregnancy

10 Later Prenatal Visits Follow-up visits usually take less time. Your doctor may also: Check your hands, feet and face for swelling Listen to the baby s heartbeat (beginning as early as week nine) Perform an ultrasound (usually at weeks 18 to 20) Measure the size of your uterus Ask about the baby s movement Typically, you will see your doctor every four weeks for the first 28 weeks of pregnancy, then every two weeks until 36 weeks of pregnancy and then weekly until your baby is born. Talk with your doctor and bring a list of questions to every visit. After Giving Birth It is important to follow up with your doctor about six weeks after the delivery. Your doctor: Will do an examination May do follow-up testing, if needed May give vaccinations, as needed The doctor may also ask if you are feeling low, have lost interest in usual activities, have difficulty caring for your baby and/or have difficulty concentrating or making decisions. Depending on your health and the health of your unborn baby, your doctor may wish to see you more often and do additional testing. The recommendations are based on information from The American College of Obstetricians and Gynecologists. The recommendations are not intended as medical advice nor meant to be a substitute for the individual medical judgment of a doctor or other health care professional. Please check with your doctor for individualized advice on the recommendations provided. Source: Guidelines for Perinatal Care, Seventh Edition, American Academy of Pediatrics and The American College of Obstetricians and Gynecologists Blue Cross and Blue Shield of Illinois, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association

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