Alcoa: Health Care: Using Your Benefits: Medical: Free Preventive Care

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Health Care


		Using Your Benefits

Medical

	Free Preventive Care

	The Basics: What Do You Pay For and When?

	What Happens When You Need Medical Care?

	Know Your Medical Costs in Advance

	Understanding Your Explanation of Benefits

	Managing Your Medical Condition

	Coordinating Your Medical Coverage with Other Coverage

	Get More Information About Your Benefits

Flexible Spending Accounts

Prescription Drug

Dental

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Free Preventive Care

Your medical plan covers routine in-network preventive care for you and your dependents at 100%. Preventive care service are free to you when you use an in-network provider, or if you live in an area where a network is not available.

Services include:

routine physical exams at any age, including medical history, prostate exam, proctosigmoidoscopic exam, pelvic exam, breast exam, weight/height, blood pressure, total cholesterol, urinalysis, blood glucose, and EKG
well-baby care
routine gynecological exam and Pap smear
routine mammogram at any age, if recommended by a doctor
routine hearing screening for preventive purposes
immunizations administered in a doctor's office or health care facility, except immunizations for travel outside the United States.

Note: As part of your annual physical, your doctor may order a test that is not part of your preventive benefit. That means you could end up being responsible for a portion of the bill.

Or, if you already have a chronic condition like diabetes or high blood pressure and your doctor writes a prescription or orders a blood test specific to that condition, the visit will not be considered a routine exam. There will be a diagnosis code filed with the claim and you will be billed for some or all of the costs for that visit.

To help avoid surprises, let your doctor know what tests are covered under your preventive benefit prior to performing tests. You can find this information on your medical claims administrator’s website:

If you are a CIGNA member

you are a Highmark member

If you are a UnitedHealthCare member

Also, ask your doctor’s office staff to code the visit as a preventive service when appropriate, to ensure that the claim is processed correctly at the 100% coverage level. If you are unsure if your claim was processed correctly, call the number on the back of your medical ID card and speak to a representative.

Recommended Screening for Adults

Screening	Recommended Timing*
Physical exam	Every 1 to 2 years until age 50, then every year
Blood pressure screening	At each office visit; minimum of once every 2 years.
Pelvic exam/breast exam	Yearly
Mammogram (for breast cancer)	Every 1 to 2 years starting at age 40
Pap test (for cervical cancer)	Yearly for women ages 19-64
Lipid panel (for cholesterol)	Routine screening every 5 years beginning at age 20. More frequent if you are at risk for cardiovascular disease.
Fasting blood glucose (for diabetes)	For high-risk patients, screenings every 3 years, starting at age 45. Earlier screenings recommended for those with risk factors.
Colorectal cancer screening	Beginning at age 50; earlier if at high risk
Prostate cancer screening	Yearly for men starting at age 50
Bone mineral density screening (for osteoporosis)	Every 2 years for women age 65 and older and men age 70 and older. Also, younger postmenopausal women who have had a fracture or have risk factors.

* Your physician may recommend a different schedule for these tests, depending upon your health and personal risk factors.