Preventive Health Care

doctor providing health check
Why Do You Need Preventive Care?

Your health care plan covers specific preventive care services. Even when you’re in the best shape of your life, a serious condition with no symptoms may put your health at risk. Using these services at the right time can help you stay healthier by:

  • Preventing certain illnesses and health conditions from happening
  • Detecting health problems at early stages, when they may be easier to treat 

To make sure you get the care you need – without any unexpected costs – it’s important for you to know:

  • What is preventive care
  • Preventive care services your plan covers 

What’s Preventive Care?
Preventive care services are provided when you don’t have any symptoms and haven’t been diagnosed with a health issue connected with the preventive service. They typically are provided during a wellness exam. You and your doctor will determine what tests and health screenings are right for you based on your:

  • Age
  • Gender
  • Personal health history
  • Current health

What’s Not Preventive Care?
When your doctor determines that you have a health issue, the additional screenings and tests after this diagnosis are no longer considered preventive. These services are covered under your plan’s medical benefits, not your preventive care benefits.

What’s Your Share of the Cost?
Many plans cover preventive care services at 100% – no additional cost to you – when you go to a health care professional in your plan’s network. Check your plan materials for details about your specific medical plan’s coverage and the provider directory for a list of health care professionals and facilities in your plan’s network.

Even when your appointment is for preventive care, you may receive other services during that exam that are not preventive. These other services are generally covered under your plan’s medical benefits, not your preventive care benefits. This means you may be responsible for paying a portion or all of the cost, depending on your plan’s deductible, copay, and coinsurance amounts.
The charts on the following pages list the services and supplies that are considered preventive care under your plan.