Preventive Screenings Can Save Your Life
Which screenings do you need?
Many serious illnesses have no signs in the early stages. It’s important to talk to your doctor about screenings even if you feel fine. Age, health, and family history determine which screenings you need. Check with your doctor to see which screenings are right for you.
2023 Preventive health chart
The quick-reference chart below lists screenings your plan covers in 2023. It is not a recommendation for how often to have a screening. Please talk to your doctor about what screenings are right for you. For more complete benefit information see your Evidence of Coverage (EOC) booklet.
| Screening | Your coverage | Copay (HMO) | Copay (PPO In Network) | Copay (PPO Out of Network) |
|---|---|---|---|---|
| Physical Exam | Once every calendar year. | $01 | $01 | 30% coinsurance |
| Wellness Visit | Once every calendar year. | $01 | $01 | 30% coinsurance |
Cancer Screenings |
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| Breast Cancer | One mammogram every 12 months—clinical breast exam once every 24 months. | $0 | $0 | 30% coinsurance |
| Cervical Cancer | Once every 24 months, or every 12 months if at high risk. | $0 | $0 | 30% coinsurance |
| Colorectal Cancer | Colonoscopy screening once every 24 months if at high risk—once every 10 years if not at high risk. | $0 | $0 | 30% coinsurance for a colorectal cancer screening exam, 30% coinsurance after deductible for barium enemas |
| Prostate Cancer | Once every 12 months. | $0 | $0 | 30% coinsurance for a prostate specific antigen (PSA) test, 30% coinsurance after deductible for a digital rectal exam |
Immunizations |
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| Flu shot | Once per flu season (fall or winter). | $0 | $0 | $0 |
| Pneumonia | As medically necessary. | $0 | $0 | $0 |
| Hepatitis B | As medically necessary. | $0 | $0 | $0 |
| COVID-19 | As medically necessary. | $0 | $0 | $0 |
Sensory Screenings |
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| Routine Hearing Exam | Once a year. | $0 | $0 | $50 after deductible |
| Routine Vision Exam | Once a year. | $0 | $0 | $50 after deductible |
| Glaucoma | Once every calendar year if you are at high risk for glaucoma. | $0 | $0 | $50 after deductible |
Other Screenings |
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| Cardiovascular Disease Testing | Once every 5 years. | $0 | $0 | 30% coinsurance |
| Diabetes | Based on test results, up to 2 screenings every 12 months. | $0 | $0 | 30% coinsurance |
| Osteoporosis | If at risk, once every 24 months or more often if medically necessary. | $0 | $0 | 30% coinsurance |
| Depression | Once every calendar year. | $0 | $0 | 30% coinsurance |
| Abdominal Aortic Aneurysms | Once per lifetime if at risk. | $0 | $0 | 30% coinsurance |
| STIs | Once every 12 months, or more often if medically necessary. | $0 | $0 | 30% coinsurance |
| HIV | Once every 12 months. | $0 | $0 | 30% coinsurance |
1A copay may apply if you receive services that address a medical condition during an annual physical or Annual Wellness Visit.