Preventive Services. All necessary procedures to prevent the occurrence of oral disease, including: Cleaning and scaling Topical application of fluoride Space maintainers
Preventive Services a) Routine outpatient obstetrical care of an uncomplicated pregnancy, including prenatal evaluation and management office visits and one post- partum office visit;
b) Prenatal laboratory tests and diagnostic services related to the outpatient care of an uncomplicated pregnancy, including those identified in the current recommendations of the United States Preventive Services Task Force that have in effect a rating of “A” or “B” or provided in the comprehensive guidelines for women’s preventive health supported by the Health Resources and Services Administration;
c) Preventive laboratory tests and services rendered to a newborn during a covered hospitalization for delivery, identified in the current recommendations of the United States Preventive Services Task Force that have in effect a rating of “A” or “B,” the Periodicity Schedule of the Bright Futures Recommendations for Pediatric Preventive Health Care, and the Uniform Panel of the Secretary’s Advisory Committee on Heritable Disorders in Newborns and Children, including the collection of adequate samples for hereditary and metabolic newborn screening and newborn hearing screening; and
d) Breastfeeding support, supplies, and consultation.
Preventive Services. In addition to the benefits listed in this provision, CareFirst will provide benefits for health exams and other services for the prevention and detection of disease, at intervals appropriate to the Member’s age, sex, and health status, in accordance with the Patient Protection and Affordable Care Act, as amended, and the Health Care and Education Reconciliation Act of 2010, as amended, as well as CareFirst preventive guidelines. At a minimum, benefits for preventive services listed in this provision will be provided once per Benefit Period. Benefits will be provided for 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 (USPSTF). This includes benefits for preventive maternity care. CareFirst will update new recommendations to the preventive benefits listed in this provision at the schedule established by the Secretary of Health and Human Services. Benefits for preventive care include the following:
A. Cancer Screening Services Benefits include:
1. Prostate Cancer Screening Benefits are available when rendered in accordance with the most current American Cancer Society’s guidelines and include a medically recognized diagnostic examination, annual digital rectal examinations, and the prostate- specific antigen (PSA) tests.
2. Colorectal Cancer Screening Colorectal cancer screening provided in accordance with the latest guidelines issued by the American Cancer Society.
3. Pap Smears Benefits are available for pap smears, including tests performed using FDA approved gynecological cytology screening technologies, at intervals appropriate to the Member’s age and health status, as determined by CareFirst.
Preventive Services. The Contractor may provide certain LTSS services in a limited fashion to members who do not currently meet the eligibility criteria for LTSS, to prevent admission, re-admission or reduce lengths of stay in an institution. These Preventive Services are outlined in ATTACHMENT A.
Preventive Services. Prophylaxis - teeth cleaning three (3) times in a fiscal year, four (4) times when medically necessary; Topical application of fluoride for children up to age 19, twice in a fiscal year; Space maintainers for children up to age 14. Oral exfoliate cytology (brush biopsy) will be covered when warranted from a visual and tactile examination.
Preventive Services. Services provided by a physician or other licensed health practitioner within the scope of his or her practice under State law to: prevent disease, disability, and other health Conditions or their progression; treat potential secondary Conditions before they happen or at an early remediable stage; prolong life; and promote physical and mental health and efficiency.
Preventive Services. TennCare cost sharing or patient liability responsibilities shall apply to covered services other than the preventive services described in TennCare rules and regulations.
Preventive Services. The inclusion of preventative services mandated under State 10 and/or Federal law pertaining to group health plans will be covered by the plan, at mandated 11 benefit levels, when using in-network providers. Mandated covered services are determined 12 based upon a person’s age and may include screenings and tests for diseases, vaccines, and 13 immunizations, well baby and well child visits and periodic physical exams. 14
Preventive Services. Benefits are provided for the following Covered Services in the amounts specified in SECTION SB - SCHEDULE OF BENEFITS of this Agreement, in accordance with a predefined schedule based on age and sex, and are exempt from the Deductible, Coinsurance and Copayment amounts.
Preventive Services. Procedures performed by properly licensed dentists to prevent the occurrence of dental disease. By way of description, such covered services include: Routine prophylaxis (cleaning), periodontal maintenance, and scaling in presence of moderate or severe gingival inflammation – full mouth, after oral evaluation; and topical application of fluoride, limited sealants, and space maintainers for eligible dependent children.
