Body To be your healthiest you, it is important that you regularly see your doctor and discuss preventive care to help you avoid serious illnesses or diseases. Routine checkups and screenings can help you avoid serious health problems by working with your doctor to help you reach your personal health and wellness goals. What is preventive care? Preventive care includes immunizations, screenings, counseling and education
to help prevent or minimize the effects of serious health conditions at no extra cost to you. The appropriate preventive care services can vary for each person based on age, gender and other risk factors, including family medical history. How do I know if preventive care is covered under my plan?
The Patient Protection and Affordable Care Act (ACA) requires plans to cover certain preventive services at 100% so you do not have to pay anything beyond your monthly premium for these services.
If your policy includes coverage for ACA preventive services, these services may be covered at no additional cost to you.
Preventive services are subject to change.
BCBSKS members: Check your contract and benefits information in BlueAccess for details on how preventive services are covered by your specific plan.
Preventive health guide
Men and women have a variety of conditions to be aware of as they age. These guides provide a list of tests and exams that women and men, respectively, should discuss with their physicians.
- Men's and Women's Health Screenings
The Reference Guide for Preventive Medicine Services is based on published literature by nationally recognized authorities in health care and the expressed opinions of participating network physicians.
Choose the age range you wish to view:
- Birth to 18 months
- 19 months - 6 years
- 7 years - 12 years
- 13 years - 18 years
- 19 years to 49 years
- 50 years to 64 years
You may also download a chart that displays information for all age groups.
This guide is based on published literature by nationally recognized authorities in health care and the expressed opinions of participating network physicians. This information is intended for educational purposes only and should not be interpreted as medical advice nor as a listing of preventive services with no-cost sharing as required under the Patient Protection and Affordable Care Act. Please consult your doctor for advice about changes that may affect your health. Some services may not be covered under your health plan. Please refer to your benefit plan document for details concerning benefits, procedures and exclusions.
References:
- The Reference Guide for Preventive Medicine is based on published literature by nationally recognized authorities in health care and the expressed opinions of participating network physicians.
- Summary of Policy Recommendations for Health Examination, American Academy of Family Physicians, Leawood, Ks., August 2005
- American Cancer Society Cancer Detection Guidelines. 2006
- Guidelines for Perinatal Care, American Academy of Pediatrics and American Academy of Obstetricians and Gynecologists 5th Edition, 2002
- American Academy of Pediatrics RedBook: 2003 Report of the Committee on Infectious Diseases. 26th ed. Elk Grove Village, Il.
- www.uspreventiveservicestaskforce.org
We applaud the role you play in our members' health. To support your efforts and continuously improve the satisfaction of our members, we have adopted national practice parameters for disease management. Our goal in adopting national parameters is to help our members attain optimal quality of life. The parameters are provided to physicians for use as guidelines to assist them in clinical decision-making, and are not intended to be rigid standards.
- Asthma Practice Guidelines - Institute for Clinical Systems Improvement (PDF)
- Attention Deficit Hyperactivity Disorder - American Academy of Child and Adolescent Psychiatry
- Bipolar Disorder Practice Guidelines - National Institute of Mental Health
- Chronic Obstructive Pulmonary Disease Practice Guideline - The Global Initiative for Chronic Obstructive Lung Disease
- Diabetes Practice Guidelines - American Diabetes Association
- Heart Failure/Coronary Heart Disease Practice Guidelines - The American College of Cardiology
- Hypertension Practice Guidelines- American College of Cardiology/American Heart Association
- Major Depression Practice Guidelines - American Psychiatric Association
Preventive Services Guidelines
Preventive services include a broad range of services (including screening tests, counseling, immunizations/vaccines). We have adopted the U.S. Preventive Services Task Force (USPSTF) Guide to Clinical Preventive Services (childhood and adolescent immunization schedule approved by: the Advisory Committee on Immunization Practices (ACIP), the American Academy of Pediatrics (AAP), and the American Academy of Family Physicians (AAFP), adult immunization schedule approved by: the Advisory Committee on Immunization Practices (ACIP), the American College of Obstetricians and Gynecologists (ACOG), and the American Academy of Family Physicians (AAFP).
Immunization Schedules (Childhood, Adolescent and Adult)
- Visit the Centers for Disease Control and Prevention (CDC) for recommended vaccines and immunizations.
- Visit the Guide to Clinical Preventive Services for recommendations made by the USPSTF for clinical preventive services.
Please have your patient refer to his or her contract, Evidence of Coverage, member handbook, certification of coverage, or any endorsement or rider, if applicable, to determine coverage. If your patient is unsure about particular coverage/benefits or has questions, please have the member call the Customer Service number on his or her ID card.