Common use of Preventive Health Benefits Clause in Contracts

Preventive Health Benefits. Each Insured is eligible to receive the following preventive services paid at 100% of the allowable charge when received from a Contracting Provider for preventive (i.e., not diagnostic or treatment) purposes. Preventive Health Services received from a Non-Contracting Provider will be subject to the cost-sharing requirements (including copayments, coinsurance and deductible), applicable hereunder, in a manner consistent with 42 U.S.C. 300gg-13 for: a. evidence-based items or services that have in effect, a rating of 'A' or 'B' in the current recommendations of the United States Preventive Services Task Force; b. immunizations that have in effect a recommendation from the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention with respect to the individual involved; c. with respect to infants, children, and adolescents, evidence-informed preventive care and screenings provided for in the comprehensive guidelines supported by the Health Resources and Services Administration; and d. with respect to women, such additional preventive care and screenings not described in item (a) as provided for in comprehensive guidelines supported by the Health Resources and Services Administration for purposes of this paragraph (including breast cancer screening and mammography screenings). A list of the preventive services covered under this section is available on our website at xxx.xxxxxx.xxx, or will be mailed to You upon request. You may request the list by calling the Customer Service number on Your Identification Card.