What is considered preventive care blue cross blue shield

Body

To be your healthiest you, it is important that you regularly see your doctor and discuss preventive care to help you avoid serious illnesses or diseases. Routine checkups and screenings can help you avoid serious health problems by working with your doctor to help you reach your personal health and wellness goals.

What is preventive care?

Preventive care includes immunizations, screenings, counseling and education to help prevent or minimize the effects of serious health conditions at no extra cost to you. The appropriate preventive care services can vary for each person based on age, gender and other risk factors, including family medical history.

How do I know if preventive care is covered under my plan?

The Patient Protection and Affordable Care Act (ACA) requires plans to cover certain preventive services at 100% so you do not have to pay anything beyond your monthly premium for these services.

If your policy includes coverage for ACA preventive services, these services may be covered at no additional cost to you.

Preventive services are subject to change.

BCBSKS members: Check your contract and benefits information in BlueAccess for details on how preventive services are covered by your specific plan.


Preventive health guide

Men and women have a variety of conditions to be aware of as they age. These guides provide a list of tests and exams that women and men, respectively, should discuss with their physicians.

  • Men's and Women's Health Screenings

The Reference Guide for Preventive Medicine Services is based on published literature by nationally recognized authorities in health care and the expressed opinions of participating network physicians.

Choose the age range you wish to view:

  • Birth to 18 months
  • 19 months - 6 years
  • 7 years - 12 years
  • 13 years - 18 years
  • 19 years to 49 years
  • 50 years to 64 years

You may also download a chart that displays information for all age groups.

This guide is based on published literature by nationally recognized authorities in health care and the expressed opinions of participating network physicians. This information is intended for educational purposes only and should not be interpreted as medical advice nor as a listing of preventive services with no-cost sharing as required under the Patient Protection and Affordable Care Act. Please consult your doctor for advice about changes that may affect your health. Some services may not be covered under your health plan. Please refer to your benefit plan document for details concerning benefits, procedures and exclusions.

References:

  • The Reference Guide for Preventive Medicine is based on published literature by nationally recognized authorities in health care and the expressed opinions of participating network physicians.
  • Summary of Policy Recommendations for Health Examination, American Academy of Family Physicians, Leawood, Ks., August 2005
  • American Cancer Society Cancer Detection Guidelines. 2006
  • Guidelines for Perinatal Care, American Academy of Pediatrics and American Academy of Obstetricians and Gynecologists 5th Edition, 2002
  • American Academy of Pediatrics RedBook: 2003 Report of the Committee on Infectious Diseases. 26th ed. Elk Grove Village, Il.
  • www.uspreventiveservicestaskforce.org

Who is this for?

What is considered preventive care blue cross blue shield

Blue Cross Blue Shield of Michigan and Blue Care Network members under age 65.

Preventive care is an important part of a healthy lifestyle because it helps you avoid or detect health problems. Some examples include annual physicals and immunizations.

Blue Cross and Blue Care Network pay for some preventive care with little or no out-of-pocket costs to you when you choose in-network care. Before you receive preventive care, make sure you know what your specific health care plan pays and what you must pay.

Preventive care keep you healthy

Annual physicals can detect health issues you may not know you have. The earlier health issues and diseases are found, the greater the opportunity for treatment and a potential cure. Preventive care includes screenings for lead, colon and breast cancers, diabetes, blood pressure, depression and osteoporosis. 

Preventive care age groups and guidelines

Preventive services

If you see an in-network doctor, and your visit is strictly for preventive care, you might not have to pay a copay, coinsurance or your deductible. Please log in and refer to your plan documents for coverage information. If you don't have one, you can register. 

You may have to pay if:

  • You receive services other than preventive care during the same visit
  • The services are used to treat, diagnose or monitor an illness, injury or health problem

What is considered preventive care?

Preventive care (sometimes called “preventative care”) is routine health care that includes screenings, services and counseling to help prevent illness, disease or other health problems. It's covered by your plan because it can help you stay healthy and lets you know if you may develop a health problem.

What are three examples of preventive services?

Annual check-ups, immunizations, and flu shots, as well as certain tests and screenings, are a few examples of preventive care. This may also be called routine care.

What is the difference between preventive and diagnostic?

For example: Preventive: A person has a routine cholesterol screening at an annual preventive care visit. Diagnostic: A person takes medication to treat high cholesterol. They visit their doctor to get their cholesterol level checked and make sure their medication dosage is right.

What is a preventive plan?

Preventive care includes things such as regular check-ups, screenings and immunizations. It may be covered without cost-sharing when you visit a doctor that is in your health plan's network. This type of care may also help you catch health problems before they become serious.