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Preventive Care

All Health Plan options include coverage at 100% for preventive services — care that detects an issue before it becomes a problem.

You’ll pay nothing for the care listed here when you see an in-network provider and the care is billed as preventive.

All Members

Lab Tests

  • Cholesterol screening, if high risk
  • BRCA1 or BRCA2 risk assessment, counseling, and testing when indicated
  • Hepatitis B screening, if increased risk
  • Hepatitis C screening, if high risk or age 18–79
  • HIV screening, ages 15–65 or if high risk
  • HIV PrEP screening
  • Screening for gonorrhea, syphilis, and chlamydia
  • Tuberculosis screening
  • Prediabetes and type 2 diabetes screening and counseling

Procedures

  • Abdominal aortic aneurysm screening
  • Cervical cancer screening
  • Colon cancer screening
  • Lung cancer screening
  • Osteoporosis screening
  • Physical therapy to prevent falls
  • Breast cancer screening
  • Sterilization, including tubal ligation

Examinations / Counseling

  • Annual wellness physical exam
  • Blood pressure monitoring
  • Depression screening
  • Diabetes counseling
  • Diet behavior counseling
  • HPV screening
  • Domestic violence screening
  • Tobacco-use counseling

Immunizations

  • Chicken pox
  • COVID-19
  • DPT
  • Hib
  • Hepatitis A and B
  • Shingles
  • HPV
  • Flu
  • MMR
  • Meningitis
  • RSV

Pregnant Members

Lab Tests

  • Anemia screening
  • Gestational diabetes screening
  • Hepatitis B screening
  • HIV screening
  • Rh incompatibility screening
  • UTI screening

Breastfeeding Support

  • Breast pump
  • Lactation counseling

Children

Lab Tests

  • Anemia screening
  • Dyslipidemia screening
  • Lead screening

Exams / Counseling

  • Dental care (early childhood)
  • Eye exams
  • Fluoride varnish
  • BMI interventions
  • Skin cancer counseling
  • Well-child exams

Immunizations

  • Polio
  • Rotavirus

Newborns

Up to 62 days of age

  • Congenital hypothyroidism screening
  • Eye medication
  • Jaundice screening
  • Hearing screening
  • Metabolic screening
  • PKU screening
  • Sickle cell screening

Preventive Care vs. Diagnostic Care

Why does it matter? When you’re in network, preventive care is generally covered in full at no cost to you. Diagnostic care may come with costs like copays or deductibles.

Preventive Care

Preventive care is precautionary and routine, like an annual physical.

Diagnostic Care

Diagnostic care diagnoses or treats new symptoms or existing problems.

Example: Colonoscopy

If your doctor recommends a colonoscopy, whether it is preventive or diagnostic depends on the reason for the test.

  • Preventive colonoscopy: A screening as a precaution due to your age.
  • Diagnostic colonoscopy: A screening because of symptoms you’re having.

If your doctor recommends a specific test or procedure, you can ask if it’s for preventive or diagnostic purposes — that way you will know what type of coverage to expect.