(men, women, children)

IN-NETWORK – Multiplan PHCS
No cost for all covered wellness and preventive care services. Max. benefit: 1 exam per year per insured History, Physical Exam, Measurements (height, weight, body mass index).

OUT-OF-NETWORK: Not covered.

(other than annual wellness exam)

IN-NETWORK – Multiplan PHCS
No cost for all covered wellness and preventive care services. See COVERED PREVENTIVE SERVICES section for complete list of covered services and benefit frequency.

OUT-OF-NETWORK: Not covered.

IN-NETWORK – Multiplan PHCS
No cost for all covered wellness and preventive care services.

OUT-OF-NETWORK: Not covered.

Covered Preventive Services for Adults
(ages 18 and older)

• Abdominal Aortic Aneurysm Screening – One-time screening for age 65-75
• Blood Pressure screening – One-time per plan year
• Cholesterol screening – One-time per plan year
• Type 2 Diabetes screening – One-time per plan year
• Hepatitis B screening for adults at high risk – One-time per plan year
• Hepatitis C screening for adults at high risk – One-time per plan year
• HIV screening & counseling – One-time per plan year
• Immunization vaccines One-time per plan year per immunization (EACH) – hepatitis A & B, herpes zoster, human papillomavirus, influenza (flu shot), measles, mumps, rubella, meningococcal, pneumococcal, tetanus, diphtheria, pertussis, and varicella
• Obesity screening & counseling – One-time per plan year
• Sexually Transmitted Infection (STI) prevention counseling – One-time per plan year
• Syphilis screening – One-time per plan year

IN-NETWORK – Multiplan PHCS
No cost for all covered wellness and preventive care services.

OUT-OF-NETWORK: Not covered.

Covered Preventive Services for Women
(ages 18 and older)

• BRCA counseling and genetic testing – One-time per plan year for Women at higher risk
• Breast Cancer Mammography Screenings – One-time per plan year for women age 40+
• Breast Cancer Chemo prevention counseling – One-time per plan year
• Cervical Cancer screening – One-time per plan year
• Gestational Diabetes screening – One-time per plan year
• Hepatitis B screening – One-time per plan year
• HIV screening & counseling – One-time per plan year
• Human Papillomavirus (HPV) DNA test – One-time every 3 years for women with normal cytology age 30+
• Osteoporosis screening – One-time per plan year for women age 60+
• Well-woman visits – To obtain recommended preventive services

IN-NETWORK – Multiplan PHCS
No cost for all covered wellness and preventive care services.

OUT-OF-NETWORK: Not covered.

Covered Preventive Services for Children
(ages 18 and older)

• Immunization vaccines One-time per plan year per immunization (EACH) – hepatitis A & B, herpes zoster, human papillomavirus, influenza (flu shot), measles, mumps, rubella, meningococcal, pneumococcal, tetanus, diphtheria, pertussis, and varicella
• Autism screening – Limited to 2 screenings up to age 26 months
• Blood Pressure screening – One-time per plan year
• Congenital Hypothyroidism screening – One-time per plan year for Newborns up to age 3 months
• Phenylketonuria (PKU) screening – One-time per plan year for Newborns up to age 3 months
• Sexually Transmitted Infection (STI) prevention counseling & screening – One-time per plan year for adolescents aged 12 to 17 years
• Tuberculin testing – One-time per plan year
• Vision screening – One-time per plan year for children up to age 5

Every subscriber is assigned a primary care provider to support overall health and wellness as well as management of chronic medical conditions and the coordination of care with local medical providers (i.e., specialists).