Preventive Care
Health Coverage

Getting the right preventive care services at the right time can help you stay healthier by:

  • Preventing certain illnesses and health conditions from happening; or
  • Detecting a health problem at a stage that may be easier to treat.
What is a Preventive Care Service

Preventive care services are provided when you don’t have any symptoms and haven’t been diagnosed with the health issue connected with the preventive service.

Receiving Other Services During Preventive Exam

Even when your appointment is for a preventive exam, you may receive other services during that exam that are not preventive care services. For example, your doctor may check on a chronic condition such as heart disease. When your doctor determines that you have a medical issue present, the additional screenings and tests after this diagnosis are no longer considered preventive. These services are covered under your plan’s medical benefits, not your preventive care benefits.

Wellness Exams
  • Well Baby
  • Well Child
  • Well-Person, including annual Well-Woman Exam
Routine Immunizations
  • Diphtheria, Tetanus Toxoids and Acellular Pertussis (DTaP, Tdap, Td)
  • Meningococcal (MCV)
  • Haemophilus influenzae type b conjugate (Hib)
  • Pneumococcal (pneumonia)
  • Hepatitis A (HepA)
  • Poliovirus (IPV)
  • Hepatitis B (HepB)
  • Rotavirus (RV)
  • Human papillomavirus (HPV)
  • Varicella (chickenpox)
  • Influenza vaccine
  • Zoster (shingles)
  • Measles, mumps and rubella (MMR)
Health Screenings and Interventions
  • Alcohol misuse screening
  • Anemia screening
  • Aspirin to prevent cardiovascular disease
  • Autism Screening
  • Bacteriuria screening
  • Breast cancer screening (mammogram)
  • Breast-feeding support/counseling, supplies
  • Cervical cancer screening (pap test) HPV DNA test with pap test
  • Chlamydia screening
  • Cholesterol/lipid disorders screening
  • Colon cancer screening
  • Congenital hypothyroidism screening
  • Critical congenital heart disease screening
  • Contraception counseling/education – Contraceptive products and services
  • Depression screening
  • Developmental screening
  • Developmental surveillance
  • Diabetes screening
  • Discussion about potential benefits/risk of breast cancer preventive medication
  • Dental caries prevention – Evaluate water source for sufficient fluoride
  • Domestic and interpersonal violence screening
  • Fall prevention in older adults – physical therapy, vitamin D supplementation
  • Folic acid supplementation
  • Genetic counseling/evaluation and BRCA1/BRCA2 testing
  • Gestational diabetes screening
  • Gonorrhea screening
  • Hearing screening – not complete hearing examination
  • Healthy diet/nutrition counseling
  • Hemoglobin or hematocrit
  • Hepatitis B screening
  • Hepatitis C screening
  • HIV screening and counseling
  • Iron supplementation
  • Lead screening
  • Lung cancer screening (low-dose computed tomography)
  • Metabolic/hemoglobinopathies – according to state law
  • Obesity screening/counseling
  • Oral health evaluation/assess for dental referral
  • Osteoporosis screening
  • PKU screening
  • Ocular (eye) medication to prevent blindness
  • Prostate cancer screening (PSA)
  • Rh incompatibility test
  • Sexually transmitted infections (STI) counseling
  • Sexually transmitted infections (STI) screening
  • Sickle cell disease screening
  • Skin cancer prevention counseling to minimize exposure to ultraviolet radiation
  • Syphilis screening
  • Tobacco use/cessation interventions
  • Tobacco use prevention (counseling to prevent initiation)
  • Tuberculin test
  • Ultrasound aortic abdominal aneurysm screening
  • Vision screening – not complete eye examination