Preventive care is important to your health and well being at any age. It can help identify any health concerns or conditions in the early stages of development. Identifying a condition in the early stages means that your treatment may be less invasive and your chance of full recovery is greater.
Your Service Benefit Plan coverage provides benefits for preventive care for adults and children. If you use Preferred providers, preventive care costs you nothing at all or very little out-of-pocket.
Annual Physicals For Adults
Both Standard and Basic Option benefits are available for annual physicals when you use a Preferred provider. You pay a copayment for the physical exam and nothing for the services and tests related to the exam. Under Standard Option, you pay $20 for care by a Preferred primary care physician and $30 for care by a Preferred specialist. If you have Basic Option, you pay $25 for care by a Preferred primary care physician and $35 for care by a Preferred specialist. Benefits are not available under either option for an annual physical examination if you use a Non-preferred physician.
The tests that are part of your annual physical exam include a chest X-ray, EKG, urinalysis, CBC and total cholesterol test. Check out page 32 of the 2010 Service Benefit Plan brochure for a more complete list of covered services.
Adult Cancer Screenings
Maintaining your health includes getting the appropriate cancer screening tests when you need them. With your Service Benefit Plan coverage, you pay only the copayment for the related office visit and nothing for the covered cancer screening when you use a Preferred physician. Covered cancer screenings include:
- Colonoscopies
- Pap smears
- Mammograms
- Prostate Specific Antigen (PSA) tests
See page 34 in the 2010 Service Benefit Plan brochure for a complete list of covered cancer screening procedures.
Adult Immunizations
Immunizations are important for good health even when you are an adult. When you use a Preferred physician, you pay the appropriate copayment amount for the office visit and you pay nothing for the following immunizations:
- Hepatitis Types A and B, based on risk or family history
- Herpes Zoster (shingles) vaccine
- Human Papillomavirus (HPV) vaccine
- Pneumonia vaccine
- Seasonal flu vaccine
- H1N1 vaccine
- Meningococcal vaccine
- Tetanus-diphtheria booster
Many Preferred retail pharmacies participate in our vaccine network and provide certain covered vaccines without cost to our members. To find out if a pharmacy near you is in our vaccine network, you can call the Retail Pharmacy Program at 1.800.624.5060.
Protecting Your Children
Your Service Benefit Plan coverage provides benefits to keep children healthy from the day they are born until they turn 22 years of age, following the American Academy of Pediatrics guidelines for routine care. Standard and Basic Option pay for healthy newborn visits and any routine inpatient or outpatient screening procedures for a new baby. As your child grows, we continue to pay for routine physicals, immunizations, laboratory tests, and routine hearing tests up to the age of 22.
What is the cost of keeping your child healthy? Nothing. When you use Preferred providers, we pay for the care in full and you pay nothing.
MyBlue Wellness Initiative
If you take our Blue Health Assessment on www.fepblue.org, you not only get an evaluation of your current health status but you can also get a MyBlue Wellness Initiative Certificate that will save you money.
The Blue Health Assessment is a quick online tool that looks at the information you provide about your habits and health. You get personalized feedback identifying potential health risks, suggestions for actions and talking points to help you discuss any health issues with your physician.
After you complete the Blue Health Assessment, we will provide you with a MyBlue Wellness Initiative Certificate. This certificate entitles you to a routine physical examination in 2010, after you complete the Blue Health Assessment, with no cost for you when you use a Preferred provider.
For more information about the preventive care benefits under your coverage, go to pages 32 through 35 in the 2010 Service Benefit Plan brochure.