Preventive Health Care Services. The Preventive Health Care Services will be provided to MEMBERS by designated MediCard Medical Service Units.
Preventive Health Care Services a. See all exclusions.*
Preventive Health Care Services. In addition to any other preventive benefits described in the group contract or certificate, the Health Plan shall cover the following preventive Services and shall not impose any cost-sharing requirements, such as Deductibles, Copayment amounts, or Coinsurance amounts to any Member receiving any of the following benefits for Services from Plan Providers: 1. Evidenced-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, except that the current recommendations of the United States Preventive Service Task Force regarding breast cancer screening, mammography, and prevention of breast cancer shall be considered the most current other than those issued in or around November 2009. (To see an updated list of the “A” or “B” rated USPSTF Services, visit: xxx.xxxxxxxxxxxxXxxxxxxxxxxxxxxxx.xxx); 2. 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. (Visit the Advisory Committee on Immunization Practices at: xxxx://xxx.xxx.xxx/vaccines/acip/index.html); 3. 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. (Visit HRSA at: xxxx://xxxx.xxxx.xxx); and 4. With respect to women, such additional preventive care and screenings, not described in paragraph 1 above, as provided for in comprehensive guidelines supported by the Health Resources and Services Administration (Visit HRSA at xxxx://xxxx.xxxx.xxx), except for those Services excluded in Exclusions. The Health Plan shall update new recommendations to the preventive benefits listed above at the schedule established by the Secretary of Health and Human Services. We cover medically appropriate preventive health Care Services based on your age, sex or other factors, as determined by your Primary Care Plan Physician in accordance with national preventive health care standards. These Services include the exam, screening tests and interpretation for: 1. Preventive care exams, including: a. Routine physical examinations and health screening tests appropriate to your age and sex; b. Well-woman examinations, including visits to obtain necessary preventive care, and preconception care and prenatal care; and c. Well childcare examinations;...
Preventive Health Care Services. We cover the following preventive Services without any Cost Sharing requirements, such as Deductibles, Copayment amounts or Coinsurance amounts to any Member receiving any of the following benefits for Services from Plan Providers:
Preventive Health Care Services. Covered Benefits include preventive health care services by a Participating Provider for the following in accordance with the A or B recommendations of the task force for the particular preventive health care service: • Alcohol Misuse screening and behavioral counseling interventions for adults by a PCP; • Cervical Cancer Screening; • Breast cancer screening with mammography. Please refer to the Summary of Coverage for the Minimum Benefit. The minimum benefit shall be adjusted to reflect increases and decreases in the Consumer Price Index. Please refer to the Summary of Coverage for the Maximums Visits under this section. Any subsequent mammography performed may be subject to the plan’s Deductible or coinsurance provisions same as any other diagnostic service. Not withstanding the A or B recommendations of the task force, an annual breast cancer screening with mammography is covered for all Members possessing at least one risk factor including, but not limited to: • A family history of breast cancer; • Being 40 years of age or older; or • A genetic predisposition to breast cancer. • Cholesterol Screening for Lipid Disorders; • Colorectal Cancer Screening tests for the early detection of colorectal cancer and adenomatous polyps or a Member who is at a high risk for colorectal cancer including Members who have a family medical history of o colorectal cancer;
Preventive Health Care Services. We cover medically appropriate preventive health care Services based on your age, sex, or other factors, as determined by your primary care Plan Physician pursuant to national preventive health care standards. These Services include the exam, screening tests and interpretation for:
Preventive Health Care Services where they are referred to in this agreement are defined as non-curative health services provided to the student by parental consent (unless otherwise allowed by current Georgia law for Confidential Services). These services will follow preventive guidelines and may include: • Health screening (e.g. Early Periodic Screening and Diagnostic Testing (EPSDT) screening) • Disease prevention (e.g. immunizations, communicable diseases, etc) • Dental services (exam, x-ray, prophy (cleaning) and sealant when indicated) • Preventive services and education such as nutritional education, mental health screening and high risk assessments and health maintenance.
Preventive Health Care Services. The services of licensed health care professionals which are provided on an outpatient basis, including routine well-child visits; diagnosis and treatment of illness and injury; laboratory tests; diagnostic x-rays; prescription drugs; radiation therapy; chemotherapy; hemodialysis; emergency room services; and outpatient alcohol and substance abuse services. Primary Care Provider (PCP): A licensed health professional responsible for performing or directly supervising the primary care services of Members.
Preventive Health Care Services. We cover medically appropriate preventive health Care Services based on your age, sex or other factors, as determined by your Primary Care Plan Physician in accordance with national preventive health care standards. These Services include the exam, screening tests and interpretation for: 1. Preventive care exams, including: a. Routine physical examinations and health screening tests appropriate to your age and sex; b. Well-woman examinations, including visits to obtain necessary preventive care, and preconception care and prenatal care; and c. Well child care examinations; 2. Routine and necessary immunizations (travel immunizations are not preventive and are covered under Outpatient Care) for children and adults in accordance with Plan guidelines. Childhood immunizations include diphtheria, pertussis, tetanus, polio, hepatitis B, measles, mumps, rubella and other immunizations as may be prescribed by the Commissioner of Health; 3. An annual pap smear, including coverage for any FDA-approved gynecologic cytology screening technology; 4. Low dose screening mammograms, including 3-D mammograms to determine the presence of breast disease is covered as follows: a. One mammogram for persons age 35 through 39; b. One mammogram biennially for persons age 40 through 49; and c. One mammogram annually for person 50 or older; 5. Adjuvant breast cancer screening, including magnetic resonance imaging (MRI), ultrasound, screening, or molecular breast imaging of the breast, if: a. A mammogram demonstrates a Class C or Class D breast density classification; or b. A woman is believed to be at an increased risk for cancer due to family history or prior personal history of breast cancer, positive genetic testing, or other indications of an increased risk for cancer as determined by a woman’s physician or advanced practice registered nurse. 6. Bone mass measurement to determine risk for osteoporosis; 7. Prostate Cancer screening including diagnostic examinations, digital rectal examinations, and prostate antigen (PSA) tests provided to men who are age 40 or older; 8. Colorectal cancer screening in accordance with screening guidelines issued by the American Cancer Society including fecal occult blood tests, flexible sigmoidoscopy, and screening colonoscopy; 9. Cholesterol test (lipid profile); 10. Diabetes screening (fasting blood glucose test); 11. Sexually Transmitted Disease (STD) screening and counseling (including chlamydia, gonorrhea, syphilis and Human Papillomavirus (H...
