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Preventive Care
All four Choices medical plans cover routine preventive care for free when you use an in-network doctor or if you live in an area where the network is not available.
Preventive care includes, but is not limited to:
- Routine physicals, at any age, which include medical history, physical exam, prostate exam, proctosigmoidoscopic exam, pelvic exam, breast exam, weight/height, blood pressure, total cholesterol, urinalysis, blood glucose, and EKG
- Routine gynecological exam and Pap smear
- A mammogram, at any age, if recommended by a doctor
- Immunizations administered in a doctor’s office or health care facility, except immunizations for the sole purpose of travel outside the United States
There is no coverage for preventive care if you choose to use a doctor who is not in the network.
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:
www.mycigna.com
www.highmarkbcbs.com
www.myhuc.com
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.
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