Promoting and protecting the health of our members by highlighting key topics in the healthcare industry.
Preventive services are provided for overall health maintenance — such as routine health/wellness exams and tests, vaccinations, well-baby care and well-child care. Health screenings and wellness exams can discover problems you may not know you have. The earlier problems are found, the greater the opportunity for treatment.
The Department of Health and Human Services Affordable Care Act has defined preventive services, to be covered with no cost-share, as described in the U.S. Preventive Services Task Force A and B recommendations, the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC), and certain guidelines for infants, children, adolescents and women supported by the Health Resources and Services Administration (HRSA) Guidelines including the American Academy of Pediatrics Bright Futures periodicity guidelines.
Certain services can be done for preventive or diagnostic reasons. When a service is performed for the purpose of preventive screening and is appropriately reported, it will be considered under the HealthChoice preventive care services benefit. Diagnostic services are considered under the HealthChoice standard plan benefits.
This is not an all-inclusive list. Qualifying coverage criteria may apply.