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Preventive Care That's 100% Covered

With the passage of national health care reform, certain preventive health care for adults and children are now covered with no cost share for you when provided by a network provider. This change will be applied to your health plan the next time it renews.1

To find out if your up to date, go to:

If you have questions about coverage for preventive services, log in to your account or call Member Service at the number on the front of your ID card.

Preventive Services with No Cost Share for Adults (Ages 19 and Older)

Screenings and Tests
General Males Females Prenatal
  • Blood pressure
  • Depression
  • Cholesterol
  • Colonoscopies and sigmoidoscopies
  • Diabetes in asymptomatic adults
  • Gonorrhea
  • Hepatitis B
  • HIV
  • Syphilis
  • Abdominal aortic aneurysm, for males older than 65-75 (once per lifetime)
  • Breast cancer mammography (at least one baseline mammogram during the 5-year period a member is age 35 through 39 and one mammogram for each member in each calendar year for a member age 40 or older)
  • Cervical cancer, including pap smears (one per calendar year)
  • Chlamydial infection
  • Osteoporosis, for women age 60 and older (one per calendar year)
  • Bacteriuria (pregnant women at 12 weeks or first prenatal visit)
  • RH incompatibility (first pregnancy visit and at 24-28 weeks gestation)
Pharmacy Services2
  • Aspirin for the prevention of heart disease
  • Breast cancer chemoprevention
  • Breast cancer screening
  • Breastfeeding
  • Alcohol misuse, includes screenings
  • Sexually transmitted diseases
  • Tobacco use
  • Obesity, includes screenings
  • Healthy diet for hyperlipidemia/risk for diet-related chronic disease
  • Folic acid supplements for women planning or capable of pregnancy, up to age 46
Immunizations3
  • Hepatitis A
  • Hepatitis B
  • Herpes zoster
  • Human papillomavirus
  • Influenza
  • Measles, mumps, rubella
  • Meningococcal
  • Pneumococcal
  • Tetanus, diphtheria, pertussis
  • Varicella

 

Preventive Services with No Cost Share for Children (Birth to 18 Years)

Screenings, Tests, and Counseling Services
General Newborns Adolescents
  • Obesity screening and counseling
  • Phenylketonuria
  • Lead
  • Developmental screening
  • Autism screening
  • Developmental surveillance
  • Psychosocial/behavioral assessment
  • Alcohol and drug use assessment
  • Dyslipidemia
  • Cervical dysplasia
  • Tuberculin test
  • Hematocrit or hemoglobin
  • Sexually transmitted diseases
  • Hearing loss, up to one year old
  • Congenital hypothyroidism
  • Sickle cell disease
  • Metabolic/hemoglobin
  • Depression, ages 12-18
Immunizations3
Ages 0-18 Ages 0-6 Ages 7-18
  • Diphtheria, tetanus, pertussis
  • Hepatitis A
  • Hepatitis B
  • Inactivated poliovirus
  • Influenza
  • Measles, mumps, rubella
  • Meningococcal
  • Pneumococcal
  • Rotavirus
  • Varicella
  • Haemophilus influenzae type B
  • Human papillomavirus
Pharmacy Services2
  • Dental caries chemoprevention, oral fluoride, up through age five
  • Iron supplements for newborns, up to one year old
  • Prophylactic eye medication for gonorrhea, for newborns up to one year old

 

Note: This applies to all health plans unless your plan has grandfathered status. Grandfathering is determined by your employer.

1. The list of preventive care services and tests that will be covered with no member cost share is subject to change upon the issuance of further guidance from the federal government pursuant to PPACA. Blue Cross Blue Shield of Massachusetts has updated its products, and certain plan designs may have expanded preventive benefits beyond what is required by national health care reform. Some grandfathered and/or self-insured plan designs may have a more limited selection.

2. A licensed clinician must prescribe these medications; this does not apply to medications available over the counter.

3. Doses, recommended ages, and recommended populations vary.