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 Benefits Guide
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Wellness Benefits

Wellness Benefits are provided under all three PPO plans and includes:
 
Routine Preventive Care
  • 100% coverage of in-network eligible charges with no deductible up to $750 annual maximum per covered person
  • Eligible charges above $750 per covered person are payable but subject to deductible and coinsurance
Routine Preventive Care includes:
  • Routine physical exams (no limit on visits)
  • Routine diagnostic tests (lab and x-ray)
  • Routine eye exams (includes contact lens fitting and refractions)
  • Routine hearing exams

Examples of Routine Preventive Care

Routine Physical Exam

Annual Prostate Exam

Blood Pressure Screening

Flu Shot

Annual Mammogram

Annual Fasting Blood Sugar Test

Clinical Breast Exam

Annual Cholesterol Test

Annual Pap Smear

Tetanus-Diphtheria Booster

Well-Baby/Child Care

Routine Lab (blood, urine) Testing
 
Periodic Preventive Tests and Services
  • Payable at 100% with no deductible and no annual maximum
Periodic Preventive Services under the Wellness Benefit are:
  • Routine Sigmoidoscopy
  • Routine Colonoscopy
  • Bone Mineral Density
  • Immunizations (excluding immunizations for foreign travel)
Wellness Benefits are not subject to age or frequency limitations.
 
 
 
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