Preventive Care
It’s care that’s used to prevent illnesses or diseases, like checkups and vaccinations.

How it works

Preventive care is 100% covered for those enrolled in the Premier Plan, Contribution Plan, Saver Plan, eCommerce PPO Plan, or a Local Plan. These services include:

  • Annual checkups for all covered family members
  • Immunizations for children and some adults
  • Seasonal flu vaccination
  • Pap tests, mammograms, colonoscopies and other screening services
  • Well-woman visits and associated preventive services
  • Preventive services for pregnant women
  • Behavioral screening and counseling

Other plan details

Your plan covers 100% of the cost of eligible preventive care services when you see a network provider. You do not need to reach your deductible or out-of-pocket maximum to get this benefit.

If you see a network provider for a regular office visit and receive preventive care, you may have to pay coinsurance or a copay for the original purpose of the visit. For example, if you visit a doctor for an infection and get a flu shot while you’re there, you’ll still be charged for the office visit.

If you enroll in the Select Local Plan or a Local Plan and see a non-network provider, you won’t be covered.

If you’re in another plan and see a non-network provider for preventive care, you’ll pay 50% of the cost, and your payment will not apply toward your out-of-pocket maximum.

 

For a complete list of eligible preventive care services, see the 2020 Associate Benefits Book. This document will control in the event of any conflict.

2019 Preventive Care

All the information on this page applies to your 2019 coverage.

See the 2020 Associate Benefits Book with 2019 Summary of Material Modifications for additional information about your benefits and eligibility.