Mammography Services. This Agreement provides coverage for low-dose screening mammograms for determining the presence of breast cancer. This coverage makes available one baseline mammogram to persons age 35-39, one mammogram biennially to persons age 40-49, and one mammogram annually to persons age 50 and over. After July 1, 1992, coverage shall be available only for screening mammograms obtained on equipment designed specifically to perform low-dose mammography in imaging facilities that have met American College of Radiology accreditation standards for mammography. These scans are Covered. Additionally, medically necessary and clinically appropriate diagnostic breast examinations using diagnostic mammography, breast magnetic resonance imaging, or breast ultrasound that evaluates an abnormality seen or suspected from a screening examination for breast cancer; or detected by another means of examination and medically necessary and clinically appropriate supplemental breast examinations using breast magnetic resonance imaging or breast ultrasound that is used to screen for breast cancer when there is no abnormality seen or suspected; and based on personal or family medical history or additional factors that may increase the individual’s risk of breast cancer are covered Your plan includes coverage for PrEP medication, as appropriate for you, and essential PrEP- related services without cost sharing, the same as any other preventive drug or service. This means that you do not have to make a copayment, pay coinsurance, satisfy a deductible or pay out-of-pocket for any part of the benefits and services listed in this summary if you receive them from an in-network provider. You may be required to pay a copay, coinsurance, and/or a deductible if you receive PrEP medication or PrEP-related services from an out-of-network provider if the same benefit or service is available from an in-network provider. • At least one FDA-approved PrEP drug, with timely access to the PrEP drug that is medically appropriate for the enrollee, as needed • HIV testing • Hepatitis B and C testing • Creatinine testing and calculated estimated creatine clearance or glomerular filtration rate • Pregnancy testing for individuals with childbearing potential • Sexually transmitted infection screening and counseling • Adherence counseling • Office visits associated with each preventive service listed above • Quarterly testing for HIV and STIs, and annually for renal functions, required to maintain a PrEP prescription.
Appears in 1 contract
Samples: Subscriber Agreement
Mammography Services. This Agreement agreement provides coverage for low-dose screening mammograms for determining the presence of breast cancer. This coverage makes available one baseline mammogram to persons age 35-39, one mammogram biennially to persons age 40-49, and one mammogram annually to persons age 50 and over. After July 1, 1992, coverage shall be available only for screening mammograms obtained on equipment designed specifically to perform low-dose mammography in imaging facilities that have met American College of Radiology accreditation standards for mammography. These scans are Coveredcovered. Additionally, medically necessary and clinically appropriate diagnostic breast examinations using diagnostic mammography, breast magnetic resonance imaging, or breast ultrasound that evaluates an abnormality seen or suspected from a screening examination for breast cancer; or detected by another means of examination and medically necessary and clinically appropriate supplemental breast examinations using breast magnetic resonance imaging or breast ultrasound that is used to screen for breast cancer when there is no abnormality seen or suspected; and based on personal or family medical history or additional factors that may increase the individual’s 's risk of breast cancer are covered covered. Your plan includes coverage for PrEP medication, as appropriate for you, and essential PrEP- related services without cost sharing, the same as any other preventive drug or service. This means that you do not have to make a copayment, pay coinsurance, satisfy a deductible or pay out-of-pocket for any part of the benefits and services listed in this summary if you receive them from an in-network provider. You may be required to pay a copay, coinsurance, and/or a deductible if you receive PrEP medication or PrEP-related services from an out-of-network provider if the same benefit or service is available from an in-network provider. • At least one FDA-approved PrEP drug, with timely access to the PrEP drug that is medically appropriate for the enrollee, as needed • HIV testing • Hepatitis B and C testing • Creatinine testing and calculated estimated creatine clearance or glomerular filtration rate • Pregnancy testing for individuals with childbearing potential • Sexually transmitted infection screening and counseling • counseling Adherence counseling • Office visits associated with each preventive service listed above • Quarterly testing for HIV and STIs, and annually for renal functions, required to maintain a PrEP prescription.
Appears in 1 contract
Samples: Group Subscriber Agreement
Mammography Services. This Agreement agreement provides coverage for low-dose screening mammograms for determining the presence of breast cancer. This coverage makes available one baseline mammogram to persons age 35-39, one mammogram biennially to persons age 40-49, and one mammogram annually to persons age 50 and over. After July 1, 1992, coverage shall be available only for screening mammograms obtained on equipment designed specifically to perform low-dose mammography in imaging facilities that have met American College of Radiology accreditation standards for mammography. These scans are Coveredcovered. Additionally, medically necessary and clinically appropriate diagnostic breast examinations using diagnostic mammography, breast magnetic resonance imaging, or breast ultrasound that evaluates an abnormality seen or suspected from a screening examination for breast cancer; or detected by another means of examination and medically necessary and clinically appropriate supplemental breast examinations using breast magnetic resonance imaging or breast ultrasound that is used to screen for breast cancer when there is no abnormality seen or suspected; and based on personal or family medical history or additional factors that may increase the individual’s 's risk of breast cancer are covered Your plan includes coverage for PrEP medication, as appropriate for you, and essential PrEP- related services without cost sharing, the same as any other preventive drug or service. This means that you do not have to make a copayment, pay coinsurance, satisfy a deductible or pay out-of-pocket for any part of the benefits and services listed in this summary if you receive them from an in-network provider. You may be required to pay a copay, coinsurance, and/or a deductible if you receive PrEP medication or PrEP-related services from an out-of-network provider if the same benefit or service is available from an in-network provider. • At least one FDA-approved PrEP drug, with timely access to the PrEP drug that is medically appropriate for the enrollee, as needed • HIV testing • Hepatitis B and C testing • Creatinine testing and calculated estimated creatine clearance or glomerular filtration rate • Pregnancy testing for individuals with childbearing potential • Sexually transmitted infection screening and counseling • counseling Adherence counseling • Office visits associated with each preventive service listed above • Quarterly testing for HIV and STIs, and annually for renal functions, required to maintain a PrEP prescription.
Appears in 1 contract
Samples: Group Subscriber Agreement
Mammography Services. This Agreement provides coverage for low-dose screening mammograms for determining the presence of breast cancer. This coverage makes available one baseline mammogram to persons age 35-39, one mammogram biennially to persons age 40-49, and one mammogram annually to persons age 50 and over. After July 1, 1992, coverage shall be available only for screening mammograms obtained on equipment designed specifically to perform low-dose mammography in imaging facilities that have met American College of Radiology accreditation standards for mammography. These scans are CoveredCovered . Additionally, medically necessary and clinically appropriate diagnostic breast examinations using diagnostic mammography, breast magnetic resonance imaging, or breast ultrasound that evaluates an abnormality seen or suspected from a screening examination for breast cancer; or detected by another means of examination and medically necessary and clinically appropriate supplemental breast examinations using breast magnetic resonance imaging or breast ultrasound that is used to screen for breast cancer when there is no abnormality seen or suspected; and based on personal or family medical history or additional factors that may increase the individual’s 's risk of breast cancer are covered Your plan includes coverage for PrEP medication, as appropriate for you, and essential PrEP- related services without cost sharing, the same as any other preventive drug or service. This means that you do not have to make a copayment, pay coinsurance, satisfy a deductible or pay out-of-pocket for any part of the benefits and services listed in this summary if you receive them from an in-network provider. You may be required to pay a copay, coinsurance, and/or a deductible if you receive PrEP medication or PrEP-related services from an out-of-network provider if the same benefit or service is available from an in-network provider. • At least one FDA-approved PrEP drug, with timely access to the PrEP drug that is medically appropriate for the enrollee, as needed • HIV testing • Hepatitis B and C testing • Creatinine testing and calculated estimated creatine clearance or glomerular filtration rate • Pregnancy testing for individuals with childbearing potential • Sexually transmitted infection screening and counseling • Adherence counseling • Office visits associated with each preventive service listed above • Quarterly testing for HIV and STIs, and annually for renal functions, required to maintain a PrEP prescription.
Appears in 1 contract
Samples: Subscriber Agreement
Mammography Services. This Agreement provides coverage for low-dose screening mammograms for determining the presence of breast cancer. This coverage makes available one baseline mammogram to persons age 35-39, one mammogram biennially to persons age 40-49, and one mammogram annually to persons age 50 and over. After July 1, 1992, coverage shall be available only for screening mammograms obtained on equipment designed specifically to perform low-dose mammography in imaging facilities that have met American College of Radiology accreditation standards for mammography. These scans are Covered. Additionally, medically necessary and clinically appropriate diagnostic breast examinations using diagnostic mammography, breast magnetic resonance imaging, or breast ultrasound that evaluates an abnormality seen or suspected from a screening examination for breast cancer; or detected by another means of examination and medically necessary and clinically appropriate supplemental breast examinations using breast magnetic resonance imaging or breast ultrasound that is used to screen for breast cancer when there is no abnormality seen or suspected; and based on personal or family medical history or additional factors that may increase the individual’s risk of breast cancer are covered Your plan includes coverage for PrEP medication, as appropriate for you, and essential PrEP- related services without cost sharing, the same as any other preventive drug or service. This means that you do not have to make a copayment, pay coinsurance, satisfy a deductible or pay out-of-pocket for any part of the benefits and services listed in this summary if you receive them from an in-network provider. You may be required to pay a copay, coinsurance, and/or a deductible if you receive PrEP medication or PrEP-related services from an out-of-network provider if the same benefit or service is available from an in-network provider. • At least one FDA-approved PrEP drug, with timely access to the PrEP drug that is medically appropriate for the enrollee, as needed • HIV testing • Hepatitis B and C testing • Creatinine testing and calculated estimated creatine clearance or glomerular filtration rate • Pregnancy testing for individuals with childbearing potential • Sexually transmitted infection screening and counseling counseling • Adherence counseling • Office visits associated with each preventive service listed above • Quarterly testing for HIV and STIs, and annually for renal functions, required to maintain a PrEP prescription.
Appears in 1 contract
Samples: Group Subscriber Agreement