Common use of Screening and Counseling Services Clause in Contracts

Screening and Counseling Services. Screenings and counseling services will provide coverage for evidence-based services that have a rating of A or B in the current recommendations of the U.S. Preventive Services Task Force (USPSTF) for individuals in certain age groups or based on risk factors. Key screenings include but are not limited to: • Abdominal aortic aneurism screening for men ages 65 to 75 years old with a history of smoking • Abdominal blood glucose and type 2 diabetes mellitus screening for adults ages 40 to 70 years old who are overweight or obese • Counseling for HIV, sexually transmitted infections and domestic violence and abuse • Falls prevention screening for adults age 65 and older • Hepatitis B screenings for persons at high risk of infection • Hepatitis C screenings for adults age 18 to 79 years old • Latent tuberculosis screening for high risk populations • Lung cancer screenings for ages 55 to 80 with a history of smoking • Preventive Physical Examinations • Health appraisal exams, laboratory and radiological tests, and early detection procedures for the purpose of a routine physical exam • Periodic tests to determine metabolic, blood hemoglobin, blood pressure, blood glucose level, and blood cholesterol level, or alternatively, a fractionated cholesterol level including a Low-Density Lipoprotein (LDL) level and a High-Density Lipoprotein (HDL) level • Periodic stool examination for the presence of blood for all persons 40 years of age or older • One baseline mammogram to persons of age 35 through 39, one mammogram biennially to persons age 40 through 49, and one mammogram annually to persons age 50 and over • Colorectal cancer screening in accordance with the evidence-based recommendations established by the United States Preventive Services Task Force for determining the presence of pre-cancerous or cancerous conditions and other health problems including: o Fecal occult blood testing (FOBT) o Flexible Sigmoidoscopy o Colonoscopy, including anesthesia services and polyp removal when performed as a screening procedure. o Virtual Colonoscopy - Requires Prior Authorization o Double contrast barium enema • Smoking Cessation Program - Refer to Smoking Cessation Counseling/Program in this Section. • Screening to determine the need for vision and hearing correction • Syphilis infection screening in persons who are at an increased risk for infection and pregnant women • Preventive screening services including screening for depression, diabetes, cholesterol, obesity, various cancers, HIV and sexually transmitted infections and counseling, as well as counseling for drug and Tobacco use, healthy eating and other common health concerns. • Health education and consultation from Practitioners/Providers to discuss lifestyle behaviors that promote health and well-being including, but not limited to, the consequences of Tobacco use, and/or smoking control, nutrition and diet recommendations, and exercise plans. For Members 19 years of age or older, health education also includes information related to lower back protection, immunization practices, breast self-examination, testicular self-examination, use of seat belts in motor vehicles and other preventive healthcare practices. • Vasectomies. There is no coverage for the reversal of vasectomies. • Certain prescription drugs for preventive care, the treatment of mental illness, behavioral health, or substance use disorders will be Covered at No Charge to you, when obtained from a participating pharmacy. See your Plan’s Covered drug list for details.

Screening and Counseling Services. Screenings and counseling services will provide coverage for evidence-based services that have a rating of A or B in the current recommendations of the U.S. Preventive Services Task Force (USPSTF) for individuals in certain age groups or based on risk factors. Key screenings include but are not limited toinclude: • Abdominal aortic aneurism screening for men ages 65 to 75 years old with a history of smoking • Abdominal blood glucose and type 2 diabetes mellitus screening for adults ages 40 to 70 years old who are overweight or obese • Counseling for HIV, sexually transmitted infections and domestic violence and abuse • Falls prevention screening for adults age 65 and older • Hepatitis B screenings for persons at high risk of infection • Hepatitis C screenings for adults age 18 to 79 years old • Latent tuberculosis screening for high risk populations • Lung cancer screenings for ages 55 to 80 with a history of smoking • Preventive Physical Examinations • Health appraisal exams, laboratory and radiological tests, and early detection procedures for the purpose of a routine physical exam • Periodic tests to determine metabolic, blood hemoglobin, blood pressure, blood glucose level, and blood cholesterol level, or alternatively, a fractionated cholesterol level including a Low-Density Lipoprotein (LDL) level and a High-Density Lipoprotein (HDL) level • Periodic stool examination for the presence of blood for all persons 40 years of age or older • One baseline mammogram to persons of age 35 through 39, one mammogram biennially to persons age 40 through 49, and one mammogram annually to persons age 50 and over • Colorectal cancer screening in accordance with the evidence-based recommendations established by the United States Preventive Services Task Force for determining the presence of pre-cancerous or cancerous conditions and other health problems including: o Fecal occult blood testing (FOBT) o Flexible Sigmoidoscopy o Colonoscopy, including anesthesia services and polyp removal when performed as a screening procedure. o Virtual Colonoscopy - Requires Prior Authorization o Double contrast barium enema • Smoking Cessation Program - Refer to Smoking Cessation Counseling/Program in this Section. • Screening to determine the need for vision and hearing correction • Syphilis infection screening in persons who are at an increased risk for infection and pregnant women Periodic glaucoma eye test • Preventive screening services including screening for depression, diabetes, cholesterol, obesity, various cancers, HIV and sexually transmitted infections and counselinginfections, as well as counseling for drug and Tobacco use, healthy eating and other common health concerns. • Health education and consultation from Practitioners/Providers to discuss lifestyle behaviors that promote health and well-being including, but not limited to, the consequences of Tobacco use, and/or smoking control, nutrition and diet recommendations, and exercise plans. For Members 19 years of age or older, health education also includes information related to lower back protection, immunization practices, breast self-examination, testicular self-examination, use of seat belts in motor vehicles and other preventive healthcare health care practices. Routine Immunization includes Coverage for Adult and Child Immunizations (shots or vaccines), in accordance with the recommendations of: • VasectomiesThe American Academy of Pediatrics • The Advisory Committee on Immunization Practices • The U.S. Preventive Services Task Force o Immunizations for routine use in children, adolescents, and adults that have, in effect, a recommendation from the Advisory Committee on Immunizations Practices of the Centers for Disease Control and Prevention (Advisory Committee) with respect to the individual involved. There is no o HPV Vaccine coverage for the reversal of vasectomies. • Certain prescription drugs for preventive care, Human Papillomavirus as approved by the treatment of mental illness, behavioral health, or substance use disorders will be Covered at No Charge to you, when obtained from a participating pharmacy. See your Plan’s Covered drug list for detailsUnited States Food and Drug Administration (FDA) and in accordance with all applicable federal and state requirements and the guidelines established by the Advisory Committee on Immunization Practices (ACIP).

Screening and Counseling Services. Screenings and counseling services will provide coverage for evidence-based services that have a rating of A or B in the current recommendations of the U.S. Preventive Services Task Force (USPSTF) for individuals in certain age groups or based on risk factors. Key screenings include but are not limited toinclude: • Abdominal aortic aneurism screening for men ages 65 to 75 years old with a history of smoking • Abdominal blood glucose and type 2 diabetes mellitus screening for adults ages 40 to 70 years old who are overweight or obese • Counseling for HIV, sexually transmitted infections diseases and domestic violence and abuse • Falls prevention screening for adults age 65 and older • Hepatitis B screenings for persons at high risk of infection • Hepatitis C screenings for adults age 18 to 79 years old • Latent tuberculosis screening for high risk populations • Lung cancer screenings for ages 55 to 80 with a history of smoking • Preventive Physical Examinations • Health appraisal exams, laboratory and radiological tests, and early detection procedures for the purpose of a routine physical exam • Periodic tests to determine metabolic, blood hemoglobin, blood pressure, blood glucose level, and blood cholesterol level, or alternatively, a fractionated cholesterol level including a Low-Density Lipoprotein (LDL) level and a High-Density Lipoprotein (HDL) level • Periodic stool examination for the presence of blood for all persons 40 years of age or older • One baseline mammogram to persons of age 35 through 39, one mammogram biennially to persons age 40 through 49, and one mammogram annually to persons age 50 and over • Colorectal cancer screening in accordance with the evidence-based recommendations established by the United States Preventive Services Task Force for determining the presence of pre-cancerous or cancerous conditions and other health problems including: o Fecal occult blood testing (FOBT) o Flexible Sigmoidoscopy o Colonoscopy, including anesthesia services and polyp removal when performed as a screening procedure. o Virtual Colonoscopy - Requires Prior Authorization o Double contrast barium enema • Smoking Cessation Program - Refer to Smoking Cessation Counseling/Program in this Section. • Screening to determine the need for vision and hearing correction • Syphilis infection screening in persons who are at an increased risk for infection and pregnant women • Periodic glaucoma eye test • Preventive screening services including screening for depression, diabetes, cholesterol, obesity, various cancers, HIV and sexually transmitted infections and counseling, as well as counseling for drug and Tobacco use, healthy eating and other common health concerns. • Health education and consultation from Practitioners/Providers to discuss lifestyle behaviors that promote health and well-being including, but not limited to, the consequences of Tobacco use, and/or smoking control, nutrition and diet recommendations, and exercise plans. For Members 19 years of age or older, health education also includes information related to lower back protection, immunization practices, breast self-examination, testicular self-examination, use of seat belts in motor vehicles and other preventive healthcare practices. • Vasectomies. There is no coverage for the reversal of vasectomies. Routine Immunization includes Coverage for Adult and Child Immunizations (shots or vaccines), in accordance with the recommendations of: • Certain prescription drugs The American Academy of Pediatrics • The Advisory Committee on Immunization Practices • The U.S. Preventive Services Task Force o Immunizations for preventive careroutine use in children, adolescents, and adults that have, in effect, a recommendation from the treatment Advisory Committee on Immunizations Practices of mental illness, behavioral health, or substance use disorders will be Covered at No Charge the Centers for Disease Control and Prevention (Advisory Committee) with respect to you, when obtained from a participating pharmacythe individual involved. See your Plan’s Covered drug list o HPV Vaccine coverage for detailsthe Human Papillomavirus as approved by the United States Food and Drug Administration (FDA) and in accordance with all applicable federal and state requirements and the guidelines established by the Advisory Committee on Immunization Practices (ACIP).

Screening and Counseling Services. Screenings and counseling services will provide coverage for evidence-based services that have a rating of A or B in the current recommendations of the U.S. Preventive Services Task Force (USPSTF) for individuals in certain age groups or based on risk factors. Key screenings include but are not limited to: • Abdominal aortic aneurism screening for men ages 65 to 75 years old with a history of smoking • Abdominal blood glucose Prediabetes and type Type 2 diabetes Diabetes mellitus screening for adults ages 40 35 to 70 years old who are overweight or obese • Counseling for HIV, sexually transmitted infections (STIs) and domestic violence and abuse • Heart Artery Calcification scans are a computed tomography scan measuring coronary artery calcium for atherosclerosis and abnormal artery structure and function. These scans are Covered for individuals between the ages of 45-65 years. Refer to the Heart Artery Calcification section for more details. • Falls prevention screening for adults age 65 and older • Hepatitis B screenings screening for persons at high risk of infection • Hepatitis C screenings screening for adults age ages 18 to 79 years old • Latent tuberculosis screening for high risk populations • Lung cancer screenings for ages 55 50 to 80 years with a history of smoking • Preventive Physical Examinations • Health appraisal exams, laboratory and radiological tests, and early detection procedures for the purpose of a routine physical exam • Periodic tests to determine metabolic, blood hemoglobin, blood pressure, blood glucose level, and blood cholesterol level, or alternatively, a fractionated cholesterol level including a Low-Density Lipoprotein (LDL) level and a High-Density Lipoprotein (HDL) level • Periodic stool examination for the presence of blood for all persons 40 45 years of age or older • One baseline mammogram to persons of age 35 through 39, one mammogram biennially every two years to persons age 40 through 49, and one mammogram annually to persons age 50 and over • Colorectal cancer screening in accordance with the evidence-based recommendations established by the United States Preventive Services Task Force for determining the presence of pre-cancerous or cancerous conditions and other health problems including: o Fecal occult blood testing (FOBT) o Flexible Sigmoidoscopy o Colonoscopy, including anesthesia services and polyp removal when performed as a screening procedure. ▪ anesthesia services are also at no Cost share to Covered members when performed as part of Colonoscopy screening o Virtual Colonoscopy - Requires Prior Authorization o Double contrast barium enema • Smoking Cessation Program - Refer to Smoking Cessation Counseling/Program in this Section. • Screening to determine the need for vision and hearing correction • Syphilis infection screening in persons who are at an increased risk for infection and pregnant women • Preventive screening services including screening for depression, diabetes, cholesterol, obesity, various cancers, HIV and sexually transmitted infections STIs and counseling, as well as counseling for drug and Tobacco use, healthy eating and other common health concerns. • Health education and consultation from In-network Practitioners/Providers to discuss lifestyle behaviors that promote health and well-being including, but not limited to, the consequences of Tobacco use, and/or smoking control, nutrition and diet recommendations, and exercise plans. For Members 19 years of age or older, health education also includes information related to lower back protection, immunization practices, breast self-examination, testicular self-examination, use of seat belts in motor vehicles and other preventive healthcare practices. • Vasectomies. There is no coverage for the reversal of vasectomies. • Certain prescription drugs for preventive care, the treatment of mental illness, behavioral health, or substance use disorders will be Covered at No Charge to you, when obtained from a participating pharmacy. See your Plan’s Covered drug list for details.

Screening and Counseling Services. Screenings and counseling services will provide coverage for evidence-based services that have a rating of A or B in the current recommendations of the U.S. Preventive Services Task Force (USPSTF) for individuals in certain age groups or based on risk factors. Key screenings include but are not limited to: • Abdominal aortic aneurism screening for men ages 65 to 75 years old with a history of smoking • Abdominal blood glucose and type Type 2 diabetes mellitus screening for adults ages 40 to 70 years old who are overweight or obese • Counseling for HIV, sexually transmitted infections and domestic violence and abuse • Falls prevention screening for adults age 65 and older • Hepatitis B screenings for persons at high risk of infection • Hepatitis C screenings for adults age ages 18 to 79 years old • Latent tuberculosis screening for high risk populations • Lung cancer Cancer screenings for ages 55 to 80 with a history of smoking • Preventive Physical Examinations • Health appraisal exams, laboratory and radiological tests, and early detection procedures for the purpose of a routine physical exam • Periodic tests to determine metabolic, blood hemoglobin, blood pressure, blood glucose level, and blood cholesterol level, or alternatively, a fractionated cholesterol level including a Low-Density Lipoprotein (LDL) level and a High-Density Lipoprotein (HDL) level • Periodic stool examination for the presence of blood for all persons 40 years of age or older • One baseline mammogram to persons of age 35 through 39, one mammogram biennially to persons age 40 through 49, and one mammogram annually to persons age 50 and over • Colorectal cancer screening in accordance with the evidence-based recommendations established by the United States Preventive Services Task Force for determining the presence of pre-cancerous or cancerous conditions and other health problems including: o Fecal occult blood testing (FOBT) o Flexible Sigmoidoscopy o Colonoscopy, including anesthesia services and polyp removal when performed as a screening procedure. procedure o Virtual Colonoscopy - Requires Prior Authorization o Double contrast barium enema • Smoking Cessation Program - Refer to Smoking Cessation Counseling/Program in this Section. • Screening to determine the need for vision and hearing correction • Syphilis infection screening in persons who are at an increased risk for infection and pregnant women • Preventive screening services including screening for depression, diabetes, cholesterol, obesity, various cancers, HIV and sexually transmitted infections and counseling, as well as counseling for drug and Tobacco use, healthy eating and other common health concerns. • Health education and consultation from In-network Practitioners/Providers to discuss lifestyle behaviors that promote health and well-being including, but not limited to, the consequences of Tobacco use, and/or smoking control, nutrition and diet recommendations, and exercise plans. For Members 19 years of age or older, health education also includes information related to lower back protection, immunization practices, breast self-examination, testicular self-examination, use of seat belts in motor vehicles and other preventive healthcare practices. • Vasectomies. There is no coverage for the reversal of vasectomies. • Certain prescription drugs for preventive care, the treatment of mental illness, behavioral health, or substance use disorders will be Covered at No Charge to you, when obtained from a participating pharmacy. See your Plan’s Covered drug list for details.

Screening and Counseling Services. Screenings and counseling services will provide coverage for evidence-based services that have a rating of A or B in the current recommendations of the U.S. Preventive Services Task Force (USPSTF) for individuals in certain age groups or based on risk factors. Key screenings include but are not limited to: • Abdominal aortic aneurism screening for men ages 65 to 75 years old with a history of smoking smoking. • Abdominal blood glucose Prediabetes and type Type 2 diabetes mellitus screening for adults ages 40 35 to 70 years old who are overweight or obese obese. • Counseling for human immunodeficiency virus (HIV), sexually transmitted infections (STIs) and domestic violence and abuse abuse. • Heart Artery Calcification scans are a computed tomography scan measuring coronary artery calcium for atherosclerosis and abnormal artery structure and function. These scans are Covered for individuals between the ages of 45-65 years. Refer to the Heart Artery Calcification section for more details. • Falls prevention screening for adults age 65 and older or older. • Hepatitis B screenings for persons at high risk of infection infection. • Hepatitis C screenings for adults age ages 18 to 79 years old old. • Latent tuberculosis screening for high high-risk populations populations. • Lung cancer screenings for ages 55 50 to 80 years with a history of smoking smoking. • Preventive Physical Examinations Examinations. • Health appraisal exams, laboratory and radiological tests, and early detection procedures for the purpose of a routine physical exam exam. • Periodic tests to determine metabolic, blood hemoglobin, blood pressure, blood glucose level, and blood cholesterol level, or alternatively, a fractionated cholesterol level including a Lowlow-Density Lipoprotein density lipoprotein (LDL) level and a Highhigh-Density Lipoprotein density lipoprotein (HDL) level level. • Periodic stool examination for the presence of blood for all persons 40 45 years of age or older older. • One baseline mammogram to persons of age 35 through 39, one mammogram biennially every two years to persons age 40 through 49, and one mammogram annually to persons age 50 and over over. • Colorectal cancer screening in accordance with the evidence-based recommendations established by the United States Preventive Services Task Force for determining the presence of pre-cancerous or cancerous conditions and other health problems including: o Fecal occult blood testing (FOBT) o Flexible Sigmoidoscopy sigmoidoscopy o Colonoscopy, including anesthesia services and polyp removal when performed as a screening procedure. ▪ anesthesia services are also at no Cost-Share to Covered members when performed as part of Colonoscopy screening o Virtual Colonoscopy - Requires colonoscopy – requires Prior Authorization o Double contrast barium enema • Smoking Cessation Program - Refer – refer to Smoking Cessation Counseling/Program in this Section. • Screening to determine the need for vision and hearing correction correction. • Syphilis infection screening in persons who are at an increased risk for infection and pregnant women women. • Preventive screening services including screening for depression, diabetes, cholesterol, obesity, various cancers, HIV and sexually transmitted infections HIV, STIs, and counseling, as well as counseling for drug and Tobacco use, healthy eating and other common health concerns. • Health education and consultation from In-network Practitioners/Providers to discuss lifestyle behaviors that promote health and well-being including, but not limited to, the consequences of Tobacco use, and/or smoking control, nutrition and diet recommendations, and exercise plans. For Members 19 years of age or older, health education also includes information related to lower back protection, immunization practices, breast self-examination, testicular self-examination, use of seat belts in motor vehicles and other preventive healthcare practices. • Vasectomies. There is no coverage for the reversal of vasectomies. • Certain prescription drugs for preventive care, the treatment of mental illness, behavioral health, or substance use disorders will be Covered at No Charge to you, when obtained from a participating pharmacy. See your Plan’s Covered drug list for details. Routine Immunization includes Coverage for Adult and Child Immunizations (shots or vaccines), in accordance with the recommendations of: • The Advisory Committee on Immunization Practices Centers for Disease Control and Prevention. • The U.S. Preventive Services Task Force (USPSTF) o HPV Vaccine coverage for the Human Papillomavirus as approved by the United States Food and Drug Administration (FDA) and in accordance with all applicable federal and state requirements and the guidelines established by the Advisory Committee on Immunization Practices (ACIP).

Screening and Counseling Services. Screenings and counseling services will provide coverage for evidence-based services that have a rating of A or B in the current recommendations of the U.S. Preventive Services Task Force (USPSTF) for individuals in certain age groups or based on risk factors. Key screenings include but are not limited toinclude: • Abdominal aortic aneurism screening screenings for men ages 65 to 75 years old with a history of smoking • Abdominal blood glucose and type 2 diabetes mellitus screening for adults ages 40 to 70 years old who are overweight or obese • Counseling for HIV, sexually transmitted infections diseases and domestic violence and abuse • Falls prevention screening for adults age 65 and older • Hepatitis B screenings for persons at high risk of infection • Hepatitis C screenings for adults age ages 18 to 79 years old • Latent tuberculosis screening for high risk populations • Lung cancer screenings for ages 55 to 80 years with a history of smoking smoking. • Preventive Physical Examinations • Health appraisal exams, laboratory and radiological tests, and early detection procedures for the purpose of a routine physical exam • Periodic tests to determine metabolic, blood hemoglobin, blood pressure, blood glucose level, and blood cholesterol level, or alternatively, a fractionated cholesterol level including a Low-Density Lipoprotein (LDL) level and a High-Density Lipoprotein (HDL) level • Periodic stool examination for the presence of blood for all persons 40 years of age or older • One baseline mammogram to persons of age 35 through 39, one mammogram biennially to persons age 40 through 49, and one mammogram annually to persons age 50 and over • Colorectal cancer screening in accordance with the evidence-based recommendations established by the United States Preventive Services Task Force for determining the presence of pre-cancerous or cancerous conditions and other health problems including: o Fecal occult blood testing (FOBT) o Flexible Sigmoidoscopy o Colonoscopy, including anesthesia services and polyp removal when performed as a screening procedure. procedure o Virtual Colonoscopy - Requires Prior Authorization o Double contrast barium enema • Smoking Cessation Program - Refer to Smoking Cessation Counseling/Program in this Section. • Screening to determine the need for vision and hearing correction • Syphilis infection screening in persons who are at an increased risk for infection and pregnant women • Periodic glaucoma eye test • Preventive screening services including screening for depression, diabetes, cholesterol, obesity, various cancers, HIV and sexually transmitted infections and counseling, as well as counseling for drug and Tobacco use, healthy eating and other common health concerns. • Health education and consultation from In-network Practitioners/Providers to discuss lifestyle behaviors that promote health and well-being including, but not limited to, the consequences of Tobacco use, and/or smoking control, nutrition and diet recommendations, and exercise plans. For Members 19 years of age or older, health education also includes information related to lower back protection, immunization practices, breast self-examination, testicular self-examination, use of seat belts in motor vehicles and other preventive healthcare health care practices. • Vasectomies. There is no coverage for the reversal of vasectomies. Routine Immunization includes Coverage for Adult and Child Immunizations (shots or vaccines), in accordance with the recommendations of: • Certain prescription drugs The American Academy of Pediatrics • The Advisory Committee on Immunization Practices • The U.S. Preventive Services Task Force o Immunizations for preventive careroutine use in children, adolescents, and adults that have, in effect, a recommendation from the treatment Advisory Committee on Immunizations Practices of mental illness, behavioral health, or substance use disorders will be Covered at No Charge the Centers for Disease Control and Prevention (Advisory Committee) with respect to you, when obtained from a participating pharmacythe individual involved. See your Plan’s Covered drug list o HPV Vaccine coverage for detailsthe Human Papillomavirus as approved by the United States Food and Drug Administration (FDA) and in accordance with all applicable federal and state requirements and the guidelines established by the Advisory Committee on Immunization Practices (ACIP).

Screening and Counseling Services. Screenings and counseling services will provide coverage for evidence-based services that have a rating of A or B in the current recommendations of the U.S. Preventive Services Task Force (USPSTF) for individuals in certain age groups or based on risk factors. Key screenings include but are not limited to: • · Abdominal aortic aneurism screening for men ages 65 to 75 years old with a history of smoking • Abdominal blood glucose smoking. · Prediabetes and type Type 2 diabetes Diabetes mellitus screening for adults ages 40 35 to 70 years old who are overweight or obese • obese. · Counseling for human immunodeficiency virus (HIV), sexually transmitted infections (STIs) and domestic violence and abuse • abuse. · Heart Artery Calcification scans are a computed tomography scan measuring coronary artery calcium for atherosclerosis and abnormal artery structure and function. These scans are Covered for individuals between the ages of 45-65 years. Refer to the Heart Artery Calcification section for more details. · Falls prevention screening for adults age 65 and older • or older. · Hepatitis B screenings for persons at high risk of infection • infection. · Hepatitis C screenings for adults age ages 18 to 79 years old • old. · Latent tuberculosis screening for high risk populations • populations. · Lung cancer screenings for ages 55 50 to 80 years with a history of smoking • smoking. · Preventive Physical Examinations • Examinations. · Health appraisal exams, laboratory and radiological tests, and early detection procedures for the purpose of a routine physical exam • exam. · Periodic tests to determine metabolic, blood hemoglobin, blood pressure, blood glucose level, and blood cholesterol level, or alternatively, a fractionated cholesterol level including a Lowlow-Density Lipoprotein density lipoprotein (LDL) level and a Highhigh-Density Lipoprotein density lipoprotein (HDL) level • level. · Periodic stool examination for the presence of blood for all persons 40 45 years of age or older • older. · One baseline mammogram to persons of age 35 through 39, one mammogram biennially every two years to persons age 40 through 49, and one mammogram annually to persons age 50 and over • · Colorectal cancer screening in accordance with the evidence-based recommendations established by the United States Preventive Services Task Force for determining the presence of pre-cancerous or cancerous conditions and other health problems including: o Fecal occult blood testing (FOBT) o Flexible Sigmoidoscopy sigmoidoscopy o Colonoscopy, including anesthesia services and polyp removal when performed as a screening procedure. o Virtual Colonoscopy - Requires colonoscopy – requires Prior Authorization o Double contrast barium enema • · Smoking Cessation Program - Refer – refer to Smoking Cessation Counseling/Program in this Section. • · Screening to determine the need for vision and hearing correction • correction. · Syphilis infection screening in persons who are at an increased risk for infection and pregnant women • women. · Preventive screening services including screening for depression, diabetes, cholesterol, obesity, various cancers, HIV and sexually transmitted infections HIV, STIs, and counseling, as well as counseling for drug and Tobacco use, healthy eating and other common health concerns. • · Health education and consultation from In-network Practitioners/Providers to discuss lifestyle behaviors that promote health and well-being including, but not limited to, the consequences of Tobacco use, and/or smoking control, nutrition and diet recommendations, and exercise plans. For Members 19 years of age or older, health education also includes information related to lower back protection, immunization practices, breast self-examination, testicular self-examination, use of seat belts in motor vehicles and other preventive healthcare practices. • Vasectomies. There is no coverage for the reversal of vasectomies. • · Certain prescription drugs for preventive care, the treatment of mental illness, behavioral health, or substance use disorders will be Covered at No Charge to you, when obtained from a participating pharmacy. See your Plan’s Covered drug list for details.

Screening and Counseling Services. Screenings and counseling services will provide coverage for evidence-based services that have a rating of A or B in the current recommendations of the U.S. Preventive Services Task Force (USPSTF) for individuals in certain age groups or based on risk factors. Key screenings include but are not limited to: • Abdominal aortic aneurism screening for men ages 65 to 75 years old with a history of smoking • Abdominal blood glucose and type 2 diabetes mellitus screening for adults ages 40 to 70 years old who are overweight or obese • Counseling for HIV, sexually transmitted infections and domestic violence and abuse • Falls prevention screening for adults age 65 and older • Hepatitis B screenings for persons at high risk of infection • Hepatitis C screenings for adults age ages 18 to 79 years old • Latent tuberculosis screening for high risk populations • Lung cancer screenings for ages 55 to 80 with a history of smoking smoking. • Preventive Physical Examinations • Health appraisal exams, laboratory and radiological tests, and early detection procedures for the purpose of a routine physical exam • Periodic tests to determine metabolic, blood hemoglobin, blood pressure, blood glucose level, and blood cholesterol level, or alternatively, a fractionated cholesterol level including a Low-Density Lipoprotein (LDL) level and a High-Density Lipoprotein (HDL) level • Periodic stool examination for the presence of blood for all persons 40 years of age or older • One baseline mammogram to persons of age 35 through 39, one mammogram biennially to persons age 40 through 49, and one mammogram annually to persons age 50 and over over. • Colorectal cancer screening in accordance with the evidence-based recommendations established by the United States Preventive Services Task Force for determining the presence of pre-cancerous or cancerous conditions and other health problems including: o Fecal occult blood testing (FOBT) o Flexible Sigmoidoscopy o Colonoscopy, including anesthesia services and polyp removal when performed as a screening procedure. procedure o Virtual Colonoscopy - Requires Prior Authorization o Double contrast barium enema • Smoking Cessation Program - Refer to Smoking Cessation Counseling/Program in this Section. • Screening to determine the need for vision and hearing correction • Syphilis infection screening in persons who are at an increased risk for infection and pregnant women • Preventive screening services including screening for depression, diabetes, cholesterol, obesity, various cancers, HIV and sexually transmitted infections and counseling, as well as counseling for drug and Tobacco use, healthy eating and other common health concerns. • Health education and consultation from In-network Practitioners/Providers to discuss lifestyle behaviors that promote health and well-being including, but not limited to, the consequences of Tobacco use, and/or smoking control, nutrition and diet recommendations, and exercise plans. For Members 19 years of age or older, health education also includes information related to lower back protection, immunization practices, breast self-examination, testicular self-examination, use of seat belts in motor vehicles and other preventive healthcare practices. • Vasectomies. There is no coverage for the reversal of vasectomies. • Certain prescription drugs for preventive care, the treatment of mental illness, behavioral health, or substance use disorders will be Covered at No Charge to you, when obtained from a participating pharmacy. See your Plan’s Covered drug list for details.

Screening and Counseling Services. Screenings and counseling services will provide coverage for evidence-based services that have a rating of A or B in the current recommendations of the U.S. Preventive Services Task Force (USPSTF) for individuals in certain age groups or based on risk factors. Key screenings include but are not limited to: • Abdominal aortic aneurism screening for men ages 65 to 75 years old with a history of smoking • Abdominal blood glucose and type 2 diabetes mellitus screening for adults ages 40 to 70 years old who are overweight or obese • Counseling for HIV, sexually transmitted infections and domestic violence and abuse • Falls prevention screening for adults age 65 and older • Hepatitis B screenings for persons at high risk of infection • Hepatitis C screenings for adults age 18 to 79 years old • Latent tuberculosis screening for high risk populations • Lung cancer screenings for ages 55 to 80 with a history of smoking • Preventive Physical Examinations • Health appraisal exams, laboratory and radiological tests, and early detection procedures for the purpose of a routine physical exam • Periodic tests to determine metabolic, blood hemoglobin, blood pressure, blood glucose level, and blood cholesterol level, or alternatively, a fractionated cholesterol level including a Low-Density Lipoprotein (LDL) level and a High-Density Lipoprotein (HDL) level • Periodic stool examination for the presence of blood for all persons 40 years of age or older • One baseline mammogram to persons of age 35 through 39, one mammogram biennially to persons age 40 through 49, and one mammogram annually to persons age 50 and over • Colorectal cancer screening in accordance with the evidence-based recommendations established by the United States Preventive Services Task Force for determining the presence of pre-cancerous or cancerous conditions and other health problems including: o Fecal occult blood testing (FOBT) o Flexible Sigmoidoscopy o Colonoscopy, including anesthesia services and polyp removal when performed as a screening procedure. procedure o Virtual Colonoscopy - Requires Prior Authorization o Double contrast barium enema • Smoking Cessation Program - Refer to Smoking Cessation Counseling/Program in this Section. • Screening to determine the need for vision and hearing correction • Syphilis infection screening in persons who are at an increased risk for infection and pregnant women • Preventive screening services including screening for depression, diabetes, cholesterol, obesity, various cancers, HIV and sexually transmitted infections and counseling, as well as counseling for drug and Tobacco use, healthy eating and other common health concerns. • Health education and consultation from Practitioners/Providers to discuss lifestyle behaviors that promote health and well-being including, but not limited to, the consequences of Tobacco use, and/or smoking control, nutrition and diet recommendations, and exercise plans. For Members 19 years of age or older, health education also includes information related to lower back protection, immunization practices, breast self-examination, testicular self-examination, use of seat belts in motor vehicles and other preventive healthcare practices. • Vasectomies. There is no coverage for the reversal of vasectomies. • Certain prescription drugs for preventive care, the treatment of mental illness, behavioral health, or substance use disorders will be Covered at No Charge to you, when obtained from a participating pharmacy. See your Plan’s Covered drug list for details.

Screening and Counseling Services. Screenings and counseling services will provide coverage for evidence-based services that have a rating of A or B in the current recommendations of the U.S. Preventive Services Task Force (USPSTF) for individuals in certain age groups or based on risk factors. Key screenings include but are not limited to: • Abdominal aortic aneurism screening for men ages 65 to 75 years old with a history of smoking smoking. • Abdominal blood glucose and type 2 diabetes mellitus screening for adults ages 40 to 70 years old who are overweight or obese obese. • Counseling for human immunodeficiency virus (HIV), sexually transmitted infections (STIs) and domestic violence and abuse abuse. • Falls prevention screening for adults age 65 and older or older. • Hepatitis B screenings for persons at high risk of infection infection. • Hepatitis C screenings for adults age ages 18 to 79 years old old. • Latent tuberculosis screening for high risk populations populations. • Lung cancer screenings for ages 55 to 80 years with a history of smoking smoking. • Preventive Physical Examinations Examinations. • Health appraisal exams, laboratory and radiological tests, and early detection procedures for the purpose of a routine physical exam exam. • Periodic tests to determine metabolic, blood hemoglobin, blood pressure, blood glucose level, and blood cholesterol level, or alternatively, a fractionated cholesterol level including a Lowlow-Density Lipoprotein density lipoprotein (LDL) level and a Highhigh-Density Lipoprotein density lipoprotein (HDL) level level. • Periodic stool examination for the presence of blood for all persons 40 years of age or older older. • One baseline mammogram to persons of age 35 through 39, one mammogram biennially to persons age 40 through 49, and one mammogram annually to persons age 50 and over • Colorectal cancer screening in accordance with the evidence-based recommendations established by the United States Preventive Services Task Force for determining the presence of pre-cancerous or cancerous conditions and other health problems including: o Fecal occult blood testing (FOBT) o Flexible Sigmoidoscopy sigmoidoscopy o Colonoscopy, including anesthesia services and polyp removal when performed as a screening procedure. o Virtual Colonoscopy - Requires colonoscopy – requires Prior Authorization o Double contrast barium enema • Smoking Cessation Program - Refer – refer to Smoking Cessation Counseling/Program in this Section. • Screening to determine the need for vision and hearing correction correction. • Syphilis infection screening in persons who are at an increased risk for infection and pregnant women women. • Preventive screening services including screening for depression, diabetes, cholesterol, obesity, various cancers, HIV and sexually transmitted infections HIV, STIs, and counseling, as well as counseling for drug and Tobacco use, healthy eating and other common health concerns. • Health education and consultation from In-network Practitioners/Providers to discuss lifestyle behaviors that promote health and well-being including, but not limited to, the consequences of Tobacco use, and/or smoking control, nutrition and diet recommendations, and exercise plans. For Members 19 years of age or older, health education also includes information related to lower back protection, immunization practices, breast self-examination, testicular self-examination, use of seat belts in motor vehicles and other preventive healthcare practices. • Vasectomies. There is no coverage for the reversal of vasectomies. • Certain prescription drugs for preventive care, the treatment of mental illness, behavioral health, or substance use disorders will be Covered at No Charge to you, when obtained from a participating pharmacy. See your Plan’s Covered drug list for details.

Screening and Counseling Services. Screenings and counseling services will provide coverage for evidence-based services that have a rating of A or B in the current recommendations of the U.S. Preventive Services Task Force (USPSTF) for individuals in certain age groups or based on risk factors. Key screenings include but are not limited to: • Abdominal aortic aneurism screening for men ages 65 to 75 years old with a history of smoking • Abdominal blood glucose and type 2 diabetes mellitus screening for adults ages 40 to 70 years old who are overweight or obese • Counseling for HIV, sexually transmitted infections and domestic violence and abuse • Falls prevention screening for adults age 65 and or older • Hepatitis B screenings for persons at high risk of infection • Hepatitis C screenings for adults age ages 18 to 79 years old • Latent tuberculosis screening for high risk populations • Lung cancer screenings for ages 55 to 80 years with a history of smoking • Preventive Physical Examinations • Health appraisal exams, laboratory and radiological tests, and early detection procedures for the purpose of a routine physical exam • Periodic tests to determine metabolic, blood hemoglobin, blood pressure, blood glucose level, and blood cholesterol level, or alternatively, a fractionated cholesterol level including a Low-Density Lipoprotein (LDL) level and a High-Density Lipoprotein (HDL) level • Periodic stool examination for the presence of blood for all persons 40 years of age or older • One baseline mammogram to persons of age 35 through 39, one mammogram biennially to persons age 40 through 49, and one mammogram annually to persons age 50 and over • Colorectal cancer screening in accordance with the evidence-based recommendations established by the United States Preventive Services Task Force for determining the presence of pre-cancerous or cancerous conditions and other health problems including: o Fecal occult blood testing (FOBT) o Flexible Sigmoidoscopy o Colonoscopy, including anesthesia services and polyp removal when performed as a screening procedure. procedure o Virtual Colonoscopy - Requires Prior Authorization o Double contrast barium enema • Smoking Cessation Program - Refer to Smoking Cessation Counseling/Program in this Section. • Screening to determine the need for vision and hearing correction • Syphilis infection screening in persons who are at an increased risk for infection and pregnant women • Preventive screening services including screening for depression, diabetes, cholesterol, obesity, various cancers, HIV and sexually transmitted infections and counseling, as well as counseling for drug and Tobacco use, healthy eating and other common health concerns. • Health education and consultation from Practitioners/Providers to discuss lifestyle behaviors that promote health and well-being including, but not limited to, the consequences of Tobacco use, and/or smoking control, nutrition and diet recommendations, and exercise plans. For Members 19 years of age or older, health education also includes information related to lower back protection, immunization practices, breast self-examination, testicular self-examination, use of seat belts in motor vehicles and other preventive healthcare practices. • Vasectomies. There is no coverage for the reversal of vasectomies. • Certain prescription drugs for preventive care, the treatment of mental illness, behavioral health, or substance use disorders will be Covered at No Charge to you, when obtained from a participating pharmacy. See your Plan’s Covered drug list for details.

Screening and Counseling Services. Screenings and counseling services will provide coverage for evidence-based services that have a rating of A or B in the current recommendations of the U.S. Preventive Services Task Force (USPSTF) for individuals in certain age groups or based on risk factors. Key screenings include but are not limited to: • Abdominal aortic aneurism screening for men ages 65 to 75 years old with a history of smoking • Abdominal blood glucose and type 2 diabetes mellitus screening for adults ages 40 to 70 years old who are overweight or obese • Counseling for HIV, sexually transmitted infections (STI) and domestic violence and abuse • Falls prevention screening for adults age 65 and older • Hepatitis B screenings for persons at high risk of infection • Hepatitis C screenings for adults age ages 18 to 79 years old • Latent tuberculosis screening for high risk populations • Lung cancer screenings for ages 55 to 80 with a history of smoking smoking. • Preventive Physical Examinations • Health appraisal exams, laboratory and radiological tests, and early detection procedures for the purpose of a routine physical exam • Periodic tests to determine metabolic, blood hemoglobin, blood pressure, blood glucose level, and blood cholesterol level, or alternatively, a fractionated cholesterol level including a Low-Density Lipoprotein (LDL) level and a High-Density Lipoprotein (HDL) level • Periodic stool examination for the presence of blood for all persons 40 years of age or older • One baseline mammogram to persons of age 35 through 39, one mammogram biennially to persons age 40 through 49, and one mammogram annually to persons age 50 and over over. • Colorectal cancer screening in accordance with the evidence-based recommendations established by the United States Preventive Services Task Force for determining the presence of pre-cancerous or cancerous conditions and other health problems including: o Fecal occult blood testing (FOBT) o Flexible Sigmoidoscopy o Colonoscopy, including anesthesia services and polyp removal when performed as a screening procedure. procedure o Virtual Colonoscopy - Requires Prior Authorization o Double contrast barium enema • Smoking Cessation Program - Refer to Smoking Cessation Counseling/Program in this Section. • Screening to determine the need for vision and hearing correction • Syphilis infection screening in persons who are at an increased risk for infection and pregnant women • Preventive screening services including screening for depression, diabetes, cholesterol, obesity, various cancers, HIV and sexually transmitted infections STIs and counseling, as well as counseling for drug and Tobacco use, healthy eating and other common health concerns. • Health education and consultation from In-network Practitioners/Providers to discuss lifestyle behaviors that promote health and well-being including, but not limited to, the consequences of Tobacco use, and/or smoking control, nutrition and diet recommendations, and exercise plans. For Members 19 years of age or older, health education also includes information related to lower back protection, immunization practices, breast self-examination, testicular self-examination, use of seat belts in motor vehicles and other preventive healthcare practices. • Vasectomies. There is no coverage for the reversal of vasectomies. • Certain prescription drugs for preventive care, the treatment of mental illness, behavioral health, or substance use disorders will be Covered at No Charge to you, when obtained from a participating pharmacy. See your Plan’s Covered drug list for details.

Screening and Counseling Services. Screenings and counseling services will provide coverage for evidence-based services that have a rating of A or B in the current recommendations of the U.S. Preventive Services Task Force (USPSTF) for individuals in certain age groups or based on risk factors. Key screenings include but are not limited to: • Abdominal aortic aneurism screening for men ages 65 to 75 years old with a history of smoking smoking. • Abdominal blood glucose Prediabetes and type Type 2 diabetes mellitus screening for adults ages 40 35 to 70 years old who are overweight or obese obese. • Counseling for human immunodeficiency virus (HIV), sexually transmitted infections (STIs) and domestic violence and abuse abuse. • Heart Artery Calcification scans are a computed tomography scan measuring coronary artery calcium for atherosclerosis and abnormal artery structure and function. These scans are Covered for individuals between the ages of 45-65 years. Refer to the Heart Artery Calcification section for more details. • Falls prevention screening for adults age 65 and older or older. • Hepatitis B screenings for persons at high risk of infection infection. • Hepatitis C screenings for adults age ages 18 to 79 years old old. • Latent tuberculosis screening for high high-risk populations populations. • Lung cancer screenings for ages 55 50 to 80 years with a history of smoking smoking. • Preventive Physical Examinations Examinations. • Health appraisal exams, laboratory and radiological tests, and early detection procedures for the purpose of a routine physical exam exam. • Periodic tests to determine metabolic, blood hemoglobin, blood pressure, blood glucose level, and blood cholesterol level, or alternatively, a fractionated cholesterol level including a Lowlow-Density Lipoprotein density lipoprotein (LDL) level and a Highhigh-Density Lipoprotein density lipoprotein (HDL) level level. • Periodic stool examination for the presence of blood for all persons 40 45 years of age or older older. • One baseline mammogram to persons of age 35 through 39, one mammogram biennially every two years to persons age 40 through 49, and one mammogram annually to persons age 50 and over over. • Colorectal cancer screening in accordance with the evidence-based recommendations established by the United States Preventive Services Task Force for determining the presence of pre-cancerous or cancerous conditions and other health problems including: o Fecal occult blood testing (FOBT) o Flexible Sigmoidoscopy sigmoidoscopy o Colonoscopy, including anesthesia services and polyp removal when performed as a screening procedure. ▪ anesthesia services are also at no Cost-Share to Covered members when performed as part of Colonoscopy screening o Virtual Colonoscopy - Requires colonoscopy – requires Prior Authorization o Double contrast barium enema • Smoking Cessation Program - Refer – refer to Smoking Cessation Counseling/Program in this Section. • Screening to determine the need for vision and hearing correction correction. • Syphilis infection screening in persons who are at an increased risk for infection and pregnant women women. • Preventive screening services including screening for depression, diabetes, cholesterol, obesity, various cancers, HIV and sexually transmitted infections HIV, STIs, and counseling, as well as counseling for drug and Tobacco use, healthy eating and other common health concerns. • Health education and consultation from In-network Practitioners/Providers to discuss lifestyle behaviors that promote health and well-being including, but not limited to, the consequences of Tobacco use, and/or smoking control, nutrition and diet recommendations, and exercise plans. For Members 19 years of age or older, health education also includes information related to lower back protection, immunization practices, breast self-examination, testicular self-examination, use of seat belts in motor vehicles and other preventive healthcare practices. • Vasectomies. There is no coverage for the reversal of vasectomies. • Certain prescription drugs for preventive care, the treatment of mental illness, behavioral health, or substance use disorders will be Covered at No Charge to you, when obtained from a participating pharmacy. See your Plan’s Covered drug list for details. Routine Immunizations‌ Routine Immunization includes Coverage for Adult and Child Immunizations (shots or vaccines), in accordance with the recommendations of: • The Advisory Committee on Immunization Practices Centers for Disease Control and Prevention. • The U.S. Preventive Services Task Force (USPSTF) o HPV Vaccine coverage for the Human Papillomavirus as approved by the United States Food and Drug Administration (FDA) and in accordance with all applicable federal and state requirements and the guidelines established by the Advisory Committee on Immunization Practices (ACIP).

Screening and Counseling Services. Screenings and counseling services will provide coverage for evidence-based services that have a rating of A or B in the current recommendations of the U.S. Preventive Services Task Force (USPSTF) for individuals in certain age groups or based on risk factors. Key screenings include but are not limited to: • Abdominal aortic aneurism screening for men ages 65 to 75 years old with a history of smoking smoking. • Abdominal blood glucose and type 2 diabetes mellitus screening for adults ages 40 to 70 years old who are overweight or obese obese. • Counseling for human immunodeficiency virus (HIV), sexually transmitted infections (STIs) and domestic violence and abuse abuse. • Falls prevention screening for adults age 65 and older older. • Hepatitis B screenings for persons at high risk of infection infection. • Hepatitis C screenings for adults age ages 18 to 79 years old old. • Latent tuberculosis screening for high risk populations populations. • Lung cancer screenings for ages 55 to 80 with a history of smoking smoking. • Preventive Physical Examinations Examinations. • Health appraisal exams, laboratory and radiological tests, and early detection procedures for the purpose of a routine physical exam exam. • Periodic tests to determine metabolic, blood hemoglobin, blood pressure, blood glucose level, and blood cholesterol level, or alternatively, a fractionated cholesterol level including a Lowlow-Density Lipoprotein density lipoprotein (LDL) level and a Highhigh-Density Lipoprotein density lipoprotein (HDL) level level. • Periodic stool examination for the presence of blood for all persons 40 years of age or older older. • One baseline mammogram to persons of age 35 through 39, one mammogram biennially to persons age 40 through 49, and one mammogram annually to persons age 50 and over over. • Colorectal cancer screening in accordance with the evidence-based recommendations established by the United States Preventive Services Task Force for determining the presence of pre-cancerous or cancerous conditions and other health problems including: o Fecal occult blood testing (FOBT) o Flexible Sigmoidoscopy sigmoidoscopy o Colonoscopy, including anesthesia services and polyp removal when performed as a screening procedure. procedure o Virtual Colonoscopy - Requires colonoscopy – requires Prior Authorization o Double contrast barium enema • Smoking Cessation Program - Refer – refer to Smoking Cessation Counseling/Program in this Section. • Screening to determine the need for vision and hearing correction correction. • Syphilis infection screening in persons who are at an increased risk for infection and pregnant women women. • Preventive screening services including screening for depression, diabetes, cholesterol, obesity, various cancers, HIV and sexually transmitted infections HIV, STIs, and counseling, as well as counseling for drug and Tobacco use, healthy eating and other common health concerns. • Health education and consultation from In-network Practitioners/Providers to discuss lifestyle behaviors that promote health and well-being including, but not limited to, the consequences of Tobacco use, and/or smoking control, nutrition and diet recommendations, and exercise plans. For Members 19 years of age or older, health education also includes information related to lower back protection, immunization practices, breast self-examination, testicular self-examination, use of seat belts in motor vehicles and other preventive healthcare practices. • Vasectomies. There is no coverage for the reversal of vasectomies. • Certain prescription drugs for preventive care, the treatment of mental illness, behavioral health, or substance use disorders will be Covered at No Charge to you, when obtained from a participating pharmacy. See your Plan’s Covered drug list for details.

Screening and Counseling Services. Screenings and counseling services will provide coverage for evidence-based services that have a rating of A or B in the current recommendations of the U.S. Preventive Services Task Force (USPSTF) for individuals in certain age groups or based on risk factors. Key screenings include but are not limited to: • Abdominal aortic aneurism screening for men ages 65 to 75 years old with a history of smoking • Abdominal blood glucose and type 2 diabetes mellitus screening for adults ages 40 to 70 years old who are overweight or obese • Counseling for HIV, sexually transmitted infections and domestic violence and abuse • Falls prevention screening for adults age 65 and older • Hepatitis B screenings for persons at high risk of infection • Hepatitis C screenings screening for adults age ages 18 to 79 years old • Latent tuberculosis screening for high risk populations • Lung cancer screenings for ages 55 to 80 with a history of smoking • Preventive Physical Examinations • Health appraisal exams, laboratory and radiological tests, and early detection procedures for the purpose of a routine physical exam • Periodic tests to determine metabolic, blood hemoglobin, blood pressure, blood glucose level, and blood cholesterol level, or alternatively, a fractionated cholesterol level including a Low-Density Lipoprotein (LDL) level and a High-Density Lipoprotein (HDL) level • Periodic stool examination for the presence of blood for all persons 40 years of age or older • One baseline mammogram to persons of age 35 through 39, one mammogram biennially to persons age 40 through 49, and one mammogram annually to persons age 50 and over over. • Colorectal cancer screening in accordance with the evidence-based recommendations established by the United States Preventive Services Task Force for determining the presence of pre-cancerous or cancerous conditions and other health problems including: o Fecal occult blood testing (FOBT) o Flexible Sigmoidoscopy o Colonoscopy, including anesthesia services and polyp removal when performed as a screening procedure. procedure o Virtual Colonoscopy - Requires Prior Authorization o Double contrast barium enema • Smoking Cessation Program - Refer to Smoking Cessation Counseling/Program in this Section. • Screening to determine the need for vision and hearing correction • Syphilis infection screening in persons who are at an increased risk for infection and pregnant women • Preventive screening services including screening for depression, diabetes, cholesterol, obesity, various cancers, HIV and sexually transmitted infections and counseling, as well as counseling for drug and Tobacco use, healthy eating and other common health concerns. • Health education and consultation from In-network Practitioners/Providers to discuss lifestyle behaviors that promote health and well-being including, but not limited to, the consequences of Tobacco use, and/or smoking control, nutrition and diet recommendations, and exercise plans. For Members 19 years of age or older, health education also includes information related to lower back protection, immunization practices, breast self-examination, testicular self-examination, use of seat belts in motor vehicles and other preventive healthcare health care practices. • Vasectomies. There is no coverage for the reversal of vasectomies. • Certain prescription drugs for preventive care, the treatment of mental illness, behavioral health, or substance use disorders will be Covered at No Charge to you, when obtained from a participating pharmacy. See your Plan’s Covered drug list for details.

Screening and Counseling Services. Screenings and counseling services will provide coverage for evidence-based services that have a rating of A or B in the current recommendations of the U.S. Preventive Services Task Force (USPSTF) for individuals in certain age groups or based on risk factors. Key screenings include but are not limited toinclude: • Abdominal aortic aneurism screening for men ages 65 to 75 years old with a history of smoking • Abdominal blood glucose and type 2 diabetes mellitus screening for adults ages 40 to 70 years old who are overweight or obese • Counseling for HIV, sexually transmitted infections and domestic violence and abuse • Falls prevention screening for adults age 65 and older • Hepatitis B screenings for persons at high risk of infection • Hepatitis C screenings for adults age 18 to 79 years old • Latent tuberculosis screening for high risk populations • Lung cancer screenings for ages 55 to 80 with a history of smoking • Preventive Physical Examinations • Health appraisal exams, laboratory and radiological tests, and early detection procedures for the purpose of a routine physical exam • Periodic tests to determine metabolic, blood hemoglobin, blood pressure, blood glucose level, and blood cholesterol level, or alternatively, a fractionated cholesterol level including a Low-Density Lipoprotein (LDL) level and a High-Density Lipoprotein (HDL) level • Periodic stool examination for the presence of blood for all persons 40 years of age or older • One baseline mammogram to persons of age 35 through 39, one mammogram biennially to persons age 40 through 49, and one mammogram annually to persons age 50 and over • Colorectal cancer screening in accordance with the evidence-based recommendations established by the United States Preventive Services Task Force for determining the presence of pre-cancerous or cancerous conditions and other health problems including: o Fecal occult blood testing (FOBT) o Flexible Sigmoidoscopy o Colonoscopy, including anesthesia services and polyp removal when performed as a screening procedure. o Virtual Colonoscopy - Requires Prior Authorization o Double contrast barium enema • Smoking Cessation Program - Refer to Smoking Cessation Counseling/Program in this Section. • Screening to determine the need for vision and hearing correction • Syphilis infection screening in persons who are at an increased risk for infection and pregnant women Periodic glaucoma eye test • Preventive screening services including screening for depression, diabetes, cholesterol, obesity, various cancers, HIV and sexually transmitted infections and counselinginfections, as well as counseling for drug and Tobacco use, healthy eating and other common health concerns. • Health education and consultation from In-network Practitioners/Providers to discuss lifestyle behaviors that promote health and well-being including, but not limited to, the consequences of Tobacco use, and/or smoking control, nutrition and diet recommendations, and exercise plans. For Members 19 years of age or older, health education also includes information related to lower back protection, immunization practices, breast self-examination, testicular self-examination, use of seat belts in motor vehicles and other preventive healthcare health care practices. Routine Immunization includes Coverage for Adult and Child Immunizations (shots or vaccines), in accordance with the recommendations of: • VasectomiesThe American Academy of Pediatrics • The Advisory Committee on Immunization Practices • The U.S. Preventive Services Task Force o Immunizations for routine use in children, adolescents, and adults that have, in effect, a recommendation from the Advisory Committee on Immunizations Practices of the Centers for Disease Control and Prevention (Advisory Committee) with respect to the individual involved. There is no o HPV Vaccine coverage for the reversal of vasectomies. • Certain prescription drugs for preventive care, Human Papillomavirus as approved by the treatment of mental illness, behavioral health, or substance use disorders will be Covered at No Charge to you, when obtained from a participating pharmacy. See your Plan’s Covered drug list for detailsUnited States Food and Drug Administration (FDA) and in accordance with all applicable federal and state requirements and the guidelines established by the Advisory Committee on Immunization Practices (ACIP).

Screening and Counseling Services. Screenings and counseling services will provide coverage for evidence-based services that have a rating of A or B in the current recommendations of the U.S. Preventive Services Task Force (USPSTF) for individuals in certain age groups or based on risk factors. Key screenings include but are not limited toinclude: • Abdominal aortic aneurism screening for men ages 65 to 75 years old with a history of smoking • Abdominal blood glucose and type 2 diabetes mellitus screening for adults ages 40 to 70 years old who are overweight or obese • Counseling for HIV, sexually transmitted infections diseases and domestic violence and abuse • Falls prevention screening for adults age 65 and or older • Hepatitis B screenings for persons at high risk of infection • Hepatitis C screenings for adults age ages 18 to 79 years old • Latent tuberculosis screening for high risk populations • Lung cancer screenings for ages 55 to 80 years with a history of smoking • Preventive Physical Examinations • Health appraisal exams, laboratory and radiological tests, and early detection procedures for the purpose of a routine physical exam • Periodic tests to determine metabolic, blood hemoglobin, blood pressure, blood glucose level, and blood cholesterol level, or alternatively, a fractionated cholesterol level including a Low-Density Lipoprotein (LDL) level and a High-Density Lipoprotein (HDL) level • Periodic stool examination for the presence of blood for all persons 40 years of age or older • One baseline mammogram to persons of age 35 through 39, one mammogram biennially to persons age 40 through 49, and one mammogram annually to persons age 50 and over • Colorectal cancer screening in accordance with the evidence-based recommendations established by the United States Preventive Services Task Force for determining the presence of pre-cancerous or cancerous conditions and other health problems including: o Fecal occult blood testing (FOBT) o Flexible Sigmoidoscopy o Colonoscopy, including anesthesia services and polyp removal when performed as a screening procedure. o Virtual Colonoscopy - Requires Prior Authorization o Double contrast barium enema • Smoking Cessation Program - Refer to Smoking Cessation Counseling/Program in this Section. • Screening to determine the need for vision and hearing correction • Syphilis infection screening in persons who are at an increased risk for infection and pregnant women • Periodic glaucoma eye test • Preventive screening services including screening for depression, diabetes, cholesterol, obesity, various cancers, HIV and sexually transmitted infections and counseling, as well as counseling for drug and Tobacco use, healthy eating and other common health concerns. • Health education and consultation from In-network Practitioners/Providers to discuss lifestyle behaviors that promote health and well-being including, but not limited to, the consequences of Tobacco use, and/or smoking control, nutrition and diet recommendations, and exercise plans. For Members 19 years of age or older, health education also includes information related to lower back protection, immunization practices, breast self-examination, testicular self-examination, use of seat belts in motor vehicles and other preventive healthcare health care practices. Routine Immunization includes Coverage for Adult and Child Immunizations (shots or vaccines), in accordance with the recommendations of: • VasectomiesThe American Academy of Pediatrics • The Advisory Committee on Immunization Practices • The U.S. Preventive Services Task Force o Immunizations for routine use in children, adolescents, and adults that have, in effect, a recommendation from the Advisory Committee on Immunizations Practices of the Centers for Disease Control and Prevention (Advisory Committee) with respect to the individual involved. There is no o HPV Vaccine coverage for the reversal Human Papillomavirus as approved by the United States Food and Drug Administration (FDA) and in accordance with all Childhood Preventive Health Services includes Coverage for Well-Child Care in accordance with the recommendations of vasectomiesthe American Academy of Pediatrics. With respect to infants, children and adolescents, evidence-informed preventive care and screenings provided for the comprehensive guidelines supported by the Health Resources and Services Administration (HRSA). Key preventive care includes: • Health appraisal exams, laboratory and radiological tests, and early detection procedures for the purpose of a routine physical exam or as required for participation in sports, school, or camp activities. • Certain prescription drugs Hearing and Vision screening for preventive carecorrection. This does not include routine eye exams or Eye Vision and Hearing screening to determine Refractions performed by eye care specialists. One Eye Refraction per Contract Year is Covered for children under age six when Medically Necessary to aid in the diagnosis of certain eye diseases. • Pediatric Vision – Please refer to the Rider at the end of this Agreement for benefit coverage and details. • Prophylactic ocular topical medication for all newborns to prevent gonococcal ophthalmia neonatorum • Behavioral Assessments • Screening for Alcohol and drug use, anemia, blood pressure, congenital hypothyroidism, depression, developmental development and surveillance, dyslipidemia, hematocrit/hemoglobin or sickle cell, lead, obesity, oral health, sexuality transmitted diseases, Phenylketonuria (PKU) and Tuberculin testing. • Skin cancer prevention behavioral counseling • Counseling from Practitioners/Providers to discuss lifestyle behaviors that promote health and well-being including, but not limited to, the treatment consequences of mental illnessTobacco use, behavioral healthand/or smoking control, nutrition and diet recommendations, and exercise plans. For Members under 19 years of age, this includes (as deemed appropriate by the Member’s Practitioner/Provider or substance use disorders will be Covered at No Charge as requested by the parents or legal guardian) education information on Alcohol and Substance Use Disorder, sexually transmitted diseases, and contraception. • Preventive benefits, as defined by the Affordable Care Act (ACA) for all recommended preventive services, including services related to youpregnancy, when obtained from a participating pharmacy. See your Plan’s Covered drug list for detailspreconception and prenatal care.

Screening and Counseling Services. Screenings and counseling services will provide coverage for evidence-based services that have a rating of A or B in the current recommendations of the U.S. Preventive Services Task Force (USPSTF) for individuals in certain age groups or based on risk factors. Key screenings include but are not limited to: • · Abdominal aortic aneurism screening for men ages 65 to 75 years old with a history of smoking • Abdominal blood glucose smoking. · Prediabetes and type Type 2 diabetes mellitus screening for adults ages 40 35 to 70 years old who are overweight or obese • obese. · Counseling for human immunodeficiency virus (HIV), sexually transmitted infections (STIs) and domestic violence and abuse • abuse. · Heart Artery Calcification scans are a computed tomography scan measuring coronary artery calcium for atherosclerosis and abnormal artery structure and function. These scans are Covered for individuals between the ages of 45-65 years. Refer to the Heart Artery Calcification section for more details. · Falls prevention screening for adults age 65 and older • or older. · Hepatitis B screenings for persons at high risk of infection • infection. · Hepatitis C screenings for adults age ages 18 to 79 years old • old. · Latent tuberculosis screening for high high-risk populations • populations. · Lung cancer screenings for ages 55 50 to 80 years with a history of smoking • smoking. · Preventive Physical Examinations • Examinations. · Health appraisal exams, laboratory and radiological tests, and early detection procedures for the purpose of a routine physical exam • exam. · Periodic tests to determine metabolic, blood hemoglobin, blood pressure, blood glucose level, and blood cholesterol level, or alternatively, a fractionated cholesterol level including a Lowlow-Density Lipoprotein density lipoprotein (LDL) level and a Highhigh-Density Lipoprotein density lipoprotein (HDL) level • level. · Periodic stool examination for the presence of blood for all persons 40 45 years of age or older • older. · One baseline mammogram to persons of age 35 through 39, one mammogram biennially every two years to persons age 40 through 49, and one mammogram annually to persons age 50 and over • over. · Colorectal cancer screening in accordance with the evidence-based recommendations established by the United States Preventive Services Task Force for determining the presence of pre-cancerous or cancerous conditions and other health problems including: o Fecal occult blood testing (FOBT) o Flexible Sigmoidoscopy sigmoidoscopy o Colonoscopy, including anesthesia services and polyp removal when performed as a screening procedure. § anesthesia services are also at no Cost-Share to Covered members when performed as part of Colonoscopy screening o Virtual Colonoscopy - Requires colonoscopy – requires Prior Authorization o Double contrast barium enema • · Smoking Cessation Program - Refer – refer to Smoking Cessation Counseling/Program in this Section. • · Screening to determine the need for vision and hearing correction • correction. · Syphilis infection screening in persons who are at an increased risk for infection and pregnant women • women. · Preventive screening services including screening for depression, diabetes, cholesterol, obesity, various cancers, HIV and sexually transmitted infections HIV, STIs, and counseling, as well as counseling for drug and Tobacco use, healthy eating and other common health concerns. • · Health education and consultation from In-network Practitioners/Providers to discuss lifestyle behaviors that promote health and well-being including, but not limited to, the consequences of Tobacco use, and/or smoking control, nutrition and diet recommendations, and exercise plans. For Members 19 years of age or older, health education also includes information related to lower back protection, immunization practices, breast self-examination, testicular self-examination, use of seat belts in motor vehicles and other preventive healthcare practices. • Vasectomies. There is no coverage for the reversal of vasectomies. • · Certain prescription drugs for preventive care, the treatment of mental illness, behavioral health, or substance use disorders will be Covered at No Charge to you, when obtained from a participating pharmacy. See your Plan’s Covered drug list for details.

Screening and Counseling Services. Screenings and counseling services will provide coverage for evidence-based services that have a rating of A or B in the current recommendations of the U.S. Preventive Services Task Force (USPSTF) for individuals in certain age groups or based on risk factors. Key screenings include but are not limited to: • Abdominal aortic aneurism screening for men ages 65 to 75 years old with a history of smoking smoking. • Abdominal blood glucose and type 2 diabetes mellitus screening for adults ages 40 to 70 years old who are overweight or obese obese. • Counseling for human immunodeficiency virus (HIV), sexually transmitted infections (STIs) and domestic violence and abuse abuse. • Falls prevention screening for adults age 65 and older older. • Hepatitis B screenings for persons at high risk of infection infection. • Hepatitis C screenings for adults age ages 18 to 79 years old old. • Latent tuberculosis screening for high risk populations populations. • Lung cancer screenings for ages 55 to 80 years with a history of smoking smoking. • Preventive Physical Examinations Examinations. • Health appraisal exams, laboratory and radiological tests, and early detection procedures for the purpose of a routine physical exam exam. • Periodic tests to determine metabolic, blood hemoglobin, blood pressure, blood glucose level, and blood cholesterol level, or alternatively, a fractionated cholesterol level including a Lowlow-Density Lipoprotein density lipoprotein (LDL) level and a Highhigh-Density Lipoprotein density lipoprotein (HDL) level level. • Periodic stool examination for the presence of blood for all persons 40 years of age or older older. • One baseline mammogram to persons of age 35 through 39, one mammogram biennially to persons age 40 through 49, and one mammogram annually to persons age 50 and over • Colorectal cancer screening in accordance with the evidence-based recommendations established by the United States Preventive Services Task Force for determining the presence of pre-cancerous or cancerous conditions and other health problems including: o Fecal occult blood testing (FOBT) o Flexible Sigmoidoscopy sigmoidoscopy o Colonoscopy, including anesthesia services and polyp removal when performed as a screening procedure. procedure o Virtual Colonoscopy colonoscopy - Requires requires Prior Authorization o Double contrast barium enema • Smoking Cessation Program - Refer refer to Smoking Cessation Counseling/Program in this Section. • Screening to determine the need for vision and hearing correction correction. • Syphilis infection screening screenings in persons who are at an increased risk for infection and pregnant women women. • Preventive screening services including screening for depression, diabetes, cholesterol, obesity, various cancers, HIV and sexually transmitted infections and counseling, as well as counseling for drug and Tobacco use, healthy eating and other common health concerns. • Health education and consultation from In-network Practitioners/Providers to discuss lifestyle behaviors that promote health and well-being including, but not limited to, the consequences of Tobacco use, and/or smoking control, nutrition and diet recommendations, and exercise plans. For Members 19 years of age or older, health education also includes information related to lower back protection, immunization practices, breast self-examination, testicular self-examination, use of seat belts in motor vehicles and other preventive healthcare practices. • Vasectomies. There is no coverage for the reversal of vasectomies. • Certain prescription drugs for preventive care, the treatment of mental illness, behavioral health, or substance use disorders will be Covered at No Charge to you, when obtained from a participating pharmacy. See your Plan’s Covered drug list for details.

Screening and Counseling Services. Screenings and counseling services will provide coverage for evidence-based services that have a rating of A or B in the current recommendations of the U.S. Preventive Services Task Force (USPSTF) for individuals in certain age groups or based on risk factors. Key screenings include but are not limited toinclude: • Abdominal aortic aneurism screening for men ages 65 to 75 years old with a history of smoking • Abdominal blood glucose and type 2 diabetes mellitus screening for adults ages 40 to 70 years old who are overweight or obese • Counseling for HIV, sexually transmitted infections diseases and domestic violence and abuse • Falls prevention screening for adults age 65 and older • Hepatitis B screenings for persons at high risk of infection • Hepatitis C screenings for adults age ages 18 to 79 years old • Latent tuberculosis screening for high risk populations • Lung cancer screenings for ages 55 to 80 with a history of smoking • Preventive Physical Examinations • Health appraisal exams, laboratory and radiological tests, and early detection procedures for the purpose of a routine physical exam • Periodic tests to determine metabolic, blood hemoglobin, blood pressure, blood glucose level, and blood cholesterol level, or alternatively, a fractionated cholesterol level including a Low-Density Lipoprotein (LDL) level and a High-Density Lipoprotein (HDL) level • Periodic stool examination for the presence of blood for all persons 40 years of age or older • One baseline mammogram to persons of age 35 through 39, one mammogram biennially to persons age 40 through 49, and one mammogram annually to persons age 50 and over • Colorectal cancer screening in accordance with the evidence-based recommendations established by the United States Preventive Services Task Force for determining the presence of pre-cancerous or cancerous conditions and other health problems including: o Fecal occult blood testing (FOBT) o Flexible Sigmoidoscopy o Colonoscopy, including anesthesia services and polyp removal when performed as a screening procedure. procedure o Virtual Colonoscopy - Requires Prior Authorization o Double contrast barium enema • Smoking Cessation Program - Refer to Smoking Cessation Counseling/Program in this Section. • Screening to determine the need for vision and hearing correction • Syphilis infection screening in persons who are at an increased risk for infection and pregnant women • Periodic glaucoma eye test • Preventive screening services including screening for depression, diabetes, cholesterol, obesity, various cancers, HIV and sexually transmitted infections and counseling, as well as counseling for drug and Tobacco use, healthy eating and other common health concerns. • Health education and consultation from In-network Practitioners/Providers to discuss lifestyle behaviors that promote health and well-being including, but not limited to, the consequences of Tobacco use, and/or smoking control, nutrition and diet recommendations, and exercise plans. For Members 19 years of age or older, health education also includes information related to lower back protection, immunization practices, breast self-examination, testicular self-examination, use of seat belts in motor vehicles and other preventive healthcare health care practices. Routine Immunization includes Coverage for Adult and Child Immunizations (shots or vaccines), in accordance with the recommendations of: • VasectomiesThe American Academy of Pediatrics • The Advisory Committee on Immunization Practices • The U.S. Preventive Services Task Force o Immunizations for routine use in children, adolescents, and adults that have, in effect, a recommendation from the Advisory Committee on Immunizations Practices of the Centers for Disease Control and Prevention (Advisory Committee) with respect to the individual involved. There is no o HPV Vaccine coverage for the reversal Human Papillomavirus as approved by the United States Food and Drug Administration (FDA) and in accordance with all Childhood Preventive Health Services includes Coverage for Well-Child Care in accordance with the recommendations of vasectomiesthe American Academy of Pediatrics. With respect to infants, children and adolescents, evidence-informed preventive care and screenings provided for the comprehensive guidelines supported by the Health Resources and Services Administration (HRSA). Key preventive care includes: • Health appraisal exams, laboratory and radiological tests, and early detection procedures for the purpose of a routine physical exam or as required for participation in sports, school, or camp activities. • Certain prescription drugs Hearing and Vision screening for preventive carecorrection. This does not include routine eye exams or Eye Vision and Hearing screening to determine Refractions performed by eye care specialists. One Eye Refraction per Contract Year is Covered for children under age six when Medically Necessary to aid in the diagnosis of certain eye diseases. • Pediatric Vision – Please refer to the Rider at the end of this Agreement for benefit coverage and details. • Prophylactic ocular topical medication for all newborns to prevent gonococcal ophthalmia neonatorum • Behavioral Assessments • Screening for Alcohol and drug use, anemia, blood pressure, congenital hypothyroidism, depression, developmental development and surveillance, dyslipidemia, hematocrit/hemoglobin or sickle cell, lead, obesity, oral health, sexuality transmitted diseases, Phenylketonuria (PKU) and Tuberculin testing. • Skin cancer prevention behavioral counseling • Counseling from Practitioners/Providers to discuss lifestyle behaviors that promote health and well-being including, but not limited to, the treatment consequences of mental illnessTobacco use, behavioral healthand/or smoking control, nutrition and diet recommendations, and exercise plans. For Members under 19 years of age, this includes (as deemed appropriate by the Member’s Practitioner/Provider or substance use disorders will be Covered at No Charge as requested by the parents or legal guardian) education information on Alcohol and Substance Use Disorder, sexually transmitted diseases, and contraception. • Preventive benefits, as defined by the Affordable Care Act (ACA) for all recommended preventive services, including services related to youpregnancy, when obtained from a participating pharmacy. See your Plan’s Covered drug list for detailspreconception and prenatal care.

Screening and Counseling Services. Screenings and counseling services will provide coverage for evidence-based services that have a rating of A or B in the current recommendations of the U.S. Preventive Services Task Force (USPSTF) for individuals in certain age groups or based on risk factors. Key screenings include but are not limited toinclude: • Abdominal aortic aneurism screening for men ages 65 to 75 years yeas old with a history of smoking • Abdominal blood glucose and type 2 diabetes mellitus screening for adults ages 40 to 70 years old who are overweight or obese • Counseling for HIV, sexually transmitted infections diseases and domestic violence and abuse • Falls prevention screening for adults age 65 and older • Hepatitis B screenings for persons at high risk of infection • Hepatitis C screenings for adults age ages 18 to 79 years old • Latent tuberculosis screening for high risk populations • Lung cancer screenings for ages 55 to 80 years with a history of smoking • Preventive Physical Examinations • Health appraisal exams, laboratory and radiological tests, and early detection procedures for the purpose of a routine physical exam • Periodic tests to determine metabolic, blood hemoglobin, blood pressure, blood glucose level, and blood cholesterol level, or alternatively, a fractionated cholesterol level including a Low-Density Lipoprotein (LDL) level and a High-Density Lipoprotein (HDL) level • Periodic stool examination for the presence of blood for all persons 40 years of age or older • One baseline mammogram to persons of age 35 through 39, one mammogram biennially to persons age 40 through 49, and one mammogram annually to persons age 50 and over • Colorectal cancer screening in accordance with the evidence-based recommendations established by the United States Preventive Services Task Force for determining the presence of pre-cancerous or cancerous conditions and other health problems including: o Fecal occult blood testing (FOBT) o Flexible Sigmoidoscopy o Colonoscopy, including anesthesia services and polyp removal when performed as a screening procedure. procedure o Virtual Colonoscopy - Requires Prior Authorization o Double contrast barium enema • Smoking Cessation Program - Refer to Smoking Cessation Counseling/Program in this Section. • Screening to determine the need for vision and hearing correction • Syphilis infection screening screenings in persons who are at an increased risk for infection and pregnant women • Periodic glaucoma eye test • Preventive screening services including screening for depression, diabetes, cholesterol, obesity, various cancers, HIV and sexually transmitted infections and counseling, as well as counseling for drug and Tobacco use, healthy eating and other common health concerns. • Health education and consultation from In-network Practitioners/Providers to discuss lifestyle behaviors that promote health and well-being including, but not limited to, the consequences of Tobacco use, and/or smoking control, nutrition and diet recommendations, and exercise plans. For Members 19 years of age or older, health education also includes information related to lower back protection, immunization practices, breast self-examination, testicular self-examination, use of seat belts in motor vehicles and other preventive healthcare health care practices. • Vasectomies. There is no coverage for the reversal of vasectomies. Routine Immunization includes Coverage for Adult and Child Immunizations (shots or vaccines), in accordance with the recommendations of: • Certain prescription drugs The American Academy of Pediatrics • The Advisory Committee on Immunization Practices • The U.S. Preventive Services Task Force o Immunizations for preventive careroutine use in children, adolescents, and adults that have, in effect, a recommendation from the treatment Advisory Committee on Immunizations Practices of mental illness, behavioral health, or substance use disorders will be Covered at No Charge the Centers for Disease Control and Prevention (Advisory Committee) with respect to you, when obtained from a participating pharmacythe individual involved. See your Plan’s Covered drug list o HPV Vaccine coverage for detailsthe Human Papillomavirus as approved by the United States Food and Drug Administration (FDA) and in accordance with all applicable federal and state requirements and the guidelines established by the Advisory Committee on Immunization Practices (ACIP).

Screening and Counseling Services. Screenings and counseling services will provide coverage for evidence-based services that have a rating of A or B in the current recommendations of the U.S. Preventive Services Task Force (USPSTF) for individuals in certain age groups or based on risk factors. Key screenings include but are not limited to: • Abdominal aortic aneurism screening for men ages 65 to 75 years old with a history of smoking • Abdominal blood glucose and type 2 diabetes mellitus screening for adults ages 40 to 70 years old who are overweight or obese • Counseling for HIV, sexually transmitted infections and domestic violence and abuse • Falls prevention screening for adults age 65 and older • Hepatitis B screenings screening for persons at high risk of infection • Hepatitis C screenings screening for adults age ages 18 to 79 years old • Latent tuberculosis screening for high risk populations • Lung cancer screenings for ages 55 to 80 years with a history of smoking • Preventive Physical Examinations • Health appraisal exams, laboratory and radiological tests, and early detection procedures for the purpose of a routine physical exam • Periodic tests to determine metabolic, blood hemoglobin, blood pressure, blood glucose level, and blood cholesterol level, or alternatively, a fractionated cholesterol level including a Low-Density Lipoprotein (LDL) level and a High-Density Lipoprotein (HDL) level • Periodic stool examination for the presence of blood for all persons 40 years of age or older • One baseline mammogram to persons of age 35 through 39, one mammogram biennially to persons age 40 through 49, and one mammogram annually to persons age 50 and over • Colorectal cancer screening in accordance with the evidence-based recommendations established by the United States Preventive Services Task Force for determining the presence of pre-cancerous or cancerous conditions and other health problems including: o Fecal occult blood testing (FOBT) o Flexible Sigmoidoscopy o Colonoscopy, including anesthesia services and polyp removal when performed as a screening procedure. procedure o Virtual Colonoscopy - Requires Prior Authorization o Double contrast barium enema • Smoking Cessation Program - Refer to Smoking Cessation Counseling/Program in this Section. • Screening to determine the need for vision and hearing correction • Syphilis infection screening in persons who are at an increased risk for infection and pregnant women • Preventive screening services including screening for depression, diabetes, cholesterol, obesity, various cancers, HIV and sexually transmitted infections and counseling, as well as counseling for drug and Tobacco use, healthy eating and other common health concerns. • Health education and consultation from In-network Practitioners/Providers to discuss lifestyle behaviors that promote health and well-being including, but not limited to, the consequences of Tobacco use, and/or smoking control, nutrition and diet recommendations, and exercise plans. For Members 19 years of age or older, health education also includes information related to lower back protection, immunization practices, breast self-examination, testicular self-examination, use of seat belts in motor vehicles and other preventive healthcare practices. • Vasectomies. There is no coverage for the reversal of vasectomies. • Certain prescription drugs for preventive care, the treatment of mental illness, behavioral health, or substance use disorders will be Covered at No Charge to you, when obtained from a participating pharmacy. See your Plan’s Covered drug list for details.

Screening and Counseling Services. Screenings and counseling services will provide coverage for evidence-based services that have a rating of A or B in the current recommendations of the U.S. Preventive Services Task Force (USPSTF) for individuals in certain age groups or based on risk factors. Key screenings include but are not limited to: • · Abdominal aortic aneurism screening for men ages 65 to 75 years old with a history of smoking • Abdominal blood glucose · Prediabetes and type Type 2 diabetes Diabetes mellitus screening for adults ages 40 35 to 70 years old who are overweight or obese • · Counseling for HIV, sexually transmitted infections (STIs) and domestic violence and abuse • · Heart Artery Calcification scans are a computed tomography scan measuring coronary artery calcium for atherosclerosis and abnormal artery structure and function. These scans are Covered for individuals between the ages of 45-65 years. Refer to the Heart Artery Calcification section for more details. · Falls prevention screening for adults age 65 and older • · Hepatitis B screenings screening for persons at high risk of infection • · Hepatitis C screenings screening for adults age ages 18 to 79 years old • · Latent tuberculosis screening for high risk populations • · Lung cancer screenings for ages 55 50 to 80 years with a history of smoking • · Preventive Physical Examinations • · Health appraisal exams, laboratory and radiological tests, and early detection procedures for the purpose of a routine physical exam • · Periodic tests to determine metabolic, blood hemoglobin, blood pressure, blood glucose level, and blood cholesterol level, or alternatively, a fractionated cholesterol level including a Low-Density Lipoprotein (LDL) level and a High-Density Lipoprotein (HDL) level • · Periodic stool examination for the presence of blood for all persons 40 45 years of age or older • · One baseline mammogram to persons of age 35 through 39, one mammogram biennially every two years to persons age 40 through 49, and one mammogram annually to persons age 50 and over • over. · Colorectal cancer screening in accordance with the evidence-based recommendations established by the United States Preventive Services Task Force for determining the presence of pre-cancerous or cancerous conditions and other health problems including: o Fecal occult blood testing (FOBT) o Flexible Sigmoidoscopy sigmoidoscopy o Colonoscopy, including anesthesia services and polyp removal when performed as a screening procedure. § anesthesia services are also at no Cost-Share to Covered members when performed as part of Colonoscopy screening o Virtual Colonoscopy - Requires colonoscopy – requires Prior Authorization o Double contrast barium enema • · Smoking Cessation Program - Refer to Smoking Cessation Counseling/Program in this Section. • · Screening to determine the need for vision and hearing correction • · Syphilis infection screening in persons who are at an increased risk for infection and pregnant women • · Preventive screening services including screening for depression, diabetes, cholesterol, obesity, various cancers, HIV and sexually transmitted infections STIs and counseling, as well as counseling for drug and Tobacco use, healthy eating and other common health concerns. • · Health education and consultation from In-network Practitioners/Providers to discuss lifestyle behaviors that promote health and well-being including, but not limited to, the consequences of Tobacco use, and/or smoking control, nutrition and diet recommendations, and exercise plans. For Members 19 years of age or older, health education also includes information related to lower back protection, immunization practices, breast self-examination, testicular self-examination, use of seat belts in motor vehicles and other preventive healthcare practices. • · Vasectomies. There is no coverage for the reversal of vasectomies. • · Certain prescription drugs for preventive care, the treatment of mental illness, behavioral health, or substance use disorders will be Covered at No Charge to you, when obtained from a participating pharmacy. See your Plan’s Covered drug list for details.

Screening and Counseling Services. Screenings and counseling services will provide coverage for evidence-based services that have a rating of A or B in the current recommendations of the U.S. Preventive Services Task Force (USPSTF) for individuals in certain age groups or based on risk factors. Key screenings include but are not limited to: • Abdominal aortic aneurism screening for men ages 65 to 75 years old with a history of smoking smoking. • Abdominal blood glucose and type 2 diabetes mellitus screening for adults ages 40 to 70 years old who are overweight or obese obese. • Counseling for human immunodeficiency virus (HIV), sexually transmitted infections (STIs) and domestic violence and abuse abuse. • Falls prevention screening for adults age 65 and older older. • Hepatitis B screenings for persons at high risk of infection infection. • Hepatitis C screenings for adults age ages 18 to 79 years old old. • Latent tuberculosis screening for high risk populations populations. • Lung cancer screenings for ages 55 to 80 years with a history of smoking smoking. • Preventive Physical Examinations Examinations. • Health appraisal exams, laboratory and radiological tests, and early detection procedures for the purpose of a routine physical exam exam. • Periodic tests to determine metabolic, blood hemoglobin, blood pressure, blood glucose level, and blood cholesterol level, or alternatively, a fractionated cholesterol level including a Lowlow-Density Lipoprotein density lipoprotein (LDL) level and a Highhigh-Density Lipoprotein density lipoprotein (HDL) level level. • Periodic stool examination for the presence of blood for all persons 40 years of age or older older. • One baseline mammogram to persons of age 35 through 39, one mammogram biennially to persons age 40 through 49, and one mammogram annually to persons age 50 and over over. • Colorectal cancer screening in accordance with the evidence-based recommendations established by the United States Preventive Services Task Force for determining the presence of pre-cancerous or cancerous conditions and other health problems including: o Fecal occult blood testing (FOBT) o Flexible Sigmoidoscopy sigmoidoscopy o Colonoscopy, including anesthesia services and polyp removal when performed as a screening procedure. procedure o Virtual Colonoscopy colonoscopy - Requires requires Prior Authorization o Double contrast barium enema • Smoking Cessation Program - Refer refer to Smoking Cessation Counseling/Program in this Section. Section.‌ • Screening to determine the need for vision and hearing correction correction. • Syphilis infection screening in persons who are at an increased risk for infection and pregnant women women. • Preventive screening services including screening for depression, diabetes, cholesterol, obesity, various cancers, HIV and sexually transmitted infections HIV, STIs, and counseling, as well as counseling for drug and Tobacco use, healthy eating and other common health concerns. • Health education and consultation from In-network Practitioners/Providers to discuss lifestyle behaviors that promote health and well-being including, but not limited to, the consequences of Tobacco use, and/or smoking control, nutrition and diet recommendations, and exercise plans. For Members 19 years of age or older, health education also includes information related to lower back protection, immunization practices, breast self-examination, testicular self-examination, use of seat belts in motor vehicles and other preventive healthcare practices. • Vasectomies. There is no coverage for the reversal of vasectomies. • Certain prescription drugs for preventive care, the treatment of mental illness, behavioral health, or substance use disorders will be Covered at No Charge to you, when obtained from a participating pharmacy. See your Plan’s Covered drug list for details.

Screening and Counseling Services. Screenings and counseling services will provide coverage for evidence-based services that have a rating of A or B in the current recommendations of the U.S. Preventive Services Task Force (USPSTF) for individuals in certain age groups or based on risk factors. Key screenings include but are not limited toinclude: • Abdominal aortic aneurism screening for men ages 65 to 75 years old with a history of smoking • Abdominal blood glucose and type 2 diabetes mellitus screening for adults ages 40 to 70 years old who are overweight or obese • Counseling for HIV, sexually transmitted infections diseases and domestic violence and abuse • Falls prevention screening for adults age 65 and older • Hepatitis B screenings for persons at high risk of infection • Hepatitis C screenings for adults age 18 to 79 years old • Latent tuberculosis screening for high risk populations • Lung cancer screenings for ages 55 to 80 with a history of smoking • Preventive Physical Examinations • Health appraisal exams, laboratory and radiological tests, and early detection procedures for the purpose of a routine physical exam • Periodic tests to determine metabolic, blood hemoglobin, blood pressure, blood glucose level, and blood cholesterol level, or alternatively, a fractionated cholesterol level including a Low-Density Lipoprotein (LDL) level and a High-Density Lipoprotein (HDL) level • Periodic stool examination for the presence of blood for all persons 40 years of age or older • One baseline mammogram to persons of age 35 through 39, one mammogram biennially to persons age 40 through 49, and one mammogram annually to persons age 50 and over • Colorectal cancer screening in accordance with the evidence-based recommendations established by the United States Preventive Services Task Force for determining the presence of pre-cancerous or cancerous conditions and other health problems including: o Fecal occult blood testing (FOBT) o Flexible Sigmoidoscopy o Colonoscopy, including anesthesia services and polyp removal when performed as a screening procedure. procedure o Virtual Colonoscopy - Requires Prior Authorization o Double contrast barium enema • Smoking Cessation Program - Refer to Smoking Cessation Counseling/Program in this Section. • Screening to determine the need for vision and hearing correction • Syphilis infection screening in persons who are at an increased risk for infection and pregnant women • Periodic glaucoma eye test • Preventive screening services including screening for depression, diabetes, cholesterol, obesity, various cancers, HIV and sexually transmitted infections and counseling, as well as counseling for drug and Tobacco use, healthy eating and other common health concerns. • Health education and consultation from Practitioners/Providers to discuss lifestyle behaviors that promote health and well-being including, but not limited to, the consequences of Tobacco use, and/or smoking control, nutrition and diet recommendations, and exercise plans. For Members 19 years of age or older, health education also includes information related to lower back protection, immunization practices, breast self-examination, testicular self-examination, use of seat belts in motor vehicles and other preventive healthcare practices. Routine Immunization includes Coverage for Adult and Child Immunizations (shots or vaccines), in accordance with the recommendations of: • VasectomiesThe American Academy of Pediatrics • The Advisory Committee on Immunization Practices • The U.S. Preventive Services Task Force o Immunizations for routine use in children, adolescents, and adults that have, in effect, a recommendation from the Advisory Committee on Immunizations Practices of the Centers for Disease Control and Prevention (Advisory Committee) with respect to the individual involved. There is no o HPV Vaccine coverage for the reversal of vasectomies. • Certain prescription drugs for preventive care, Human Papillomavirus as approved by the treatment of mental illness, behavioral health, or substance use disorders will be Covered at No Charge to you, when obtained from a participating pharmacy. See your Plan’s Covered drug list for detailsUnited States Food and Drug Administration (FDA) and in accordance with all applicable federal and state requirements and the guidelines established by the Advisory Committee on Immunization Practices (ACIP).