Preventive services are reimbursed, up to 130% of the national rate.  Checks are issued by HealthShare Works to members within 30 days of receiving the itemized invoice.

Preventive care benefits for all adults

·        Abdominal aortic aneurysm one-time screening for men of specified ages who have ever smoked

·        Alcohol misuse screening and counseling

·        Aspirin use to prevent cardiovascular disease and colorectal cancer for adults 50 to 59 years with a high cardiovascular risk

·        Blood pressure screening

·        Cholesterol screening for adults of certain ages or at higher risk

·        Colorectal cancer screening for adults 50 to 75

·        Depression screening

·        Diabetes (Type 2) screening for adults 40 to 70 years who are overweight or obese

·        Diet counseling for adults at higher risk for chronic disease

·        Falls prevention (with exercise or physical therapy and vitamin D use) for adults 65 years and over, living in a community setting

·        Hepatitis B screening for people at high risk, including people from countries with 2% or more Hepatitis B prevalence, and U.S.-born people not vaccinated as infants and with at least one parent born in a region with 8% or more Hepatitis B prevalence.

·        Hepatitis C screening for adults at increased risk, and one time for everyone born 1945–1965

·        HIV screening for everyone ages 15 to 65, and other ages at increased risk

·        Immunization vaccines for adults — doses, recommended ages, and recommended populations vary:

·        Diphtheria

·        Hepatitis A

·        Hepatitis B

·        Herpes Zoster

·        Human Papillomavirus (HPV)

·        Influenza (flu shot)

·        Measles

·        Meningococcal

·        Mumps

·        Pertussis

·        Pneumococcal

·        Rubella

·        Tetanus

·        Varicella (Chickenpox)

·        Lung cancer screening for adults 55-80 at high risk for lung cancer because they’re heavy smokers or have quit in the past 15 years

·        Obesity screening and counseling

·        Sexually transmitted infection (STI) prevention counseling for adults at higher risk

·        Statin preventive medication for adults 40 to 75 at high risk

·        Syphilis screening for adults at higher risk

·        Tobacco use screening for all adults and cessation interventions for tobacco users

·        Tuberculosis screening for certain adults without symptoms at high risk

 

Services for pregnant women or women who may become pregnant

·        Anemia screening on a routine basis

·        Breastfeeding comprehensive support and counseling from trained providers, and access to breastfeeding supplies, for pregnant and nursing women

·        Contraception: Food and Drug Administration-approved contraceptive methods, sterilization procedures, and patient education and counseling, as prescribed by a health care provider for women with reproductive capacity (not including abortifacient drugs).

·        Folic acid supplements for women who may become pregnant

·        Gestational diabetes screening for women 24 to 28 weeks pregnant and those at high risk of developing gestational diabetes

·        Gonorrhea screening for all women at higher risk

·        Hepatitis B screening for pregnant women at their first prenatal visit

·        Preeclampsia prevention and screening for pregnant women with high blood pressure

·        Rh incompatibility screening for all pregnant women and follow-up testing for women at higher risk

·        Syphilis screening

·        Expanded tobacco intervention and counseling for pregnant tobacco users

·        Urinary tract or other infection screening

 

Other Preventive care benefits for women

·        Breast cancer genetic test counseling (BRCA) for women at higher risk

·        Breast cancer mammography screenings every 1 to 2 years for women over 40

·        Breast cancer chemoprevention counseling for women at higher risk

·        Cervical cancer screening

·        Pap test (also called a Pap smear) every 3 years for women 21 to 65

·        Human Papillomavirus (HPV) DNA test with the combination of a Pap smear every 5 years for women 30 to 65 who don’t want a Pap smear every 3 years

·        Chlamydia infection screening for younger women and other women at higher risk

·        Diabetes screening for women with a history of gestational diabetes who aren’t currently pregnant and who haven’t been diagnosed with type 2 diabetes before

·        Domestic and interpersonal violence screening and counseling for all women

·        Gonorrhea screening for all women at higher risk

·        HIV screening and counseling for sexually active women

·        Osteoporosis screening for women over age 60 depending on risk factors

·        Rh incompatibility screening follow-up testing for women at higher risk

·        Sexually transmitted infections counseling for sexually active women

·        Syphilis screening for women at increased risk

·        Tobacco use screening and interventions

·        Urinary incontinence screening for women yearly

·        Well-woman visits to get recommended services for women under 65

 

Preventive care benefits for children

·        Alcohol, tobacco, and drug use assessments for adolescents

·        Autism screening for children at 18 and 24 months

·        Behavioral assessments for children ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years

·        Bilirubin concentration screening for newborns

·        Blood pressure screening for children ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years

·        Blood screening for newborns

·        Cervical dysplasia screening for sexually active females

·        Depression screening for adolescents beginning routinely at age 12

·        Developmental screening for children under age 3

·        Dyslipidemia screening for all children once between 9 and 11 years and once between 17 and 21 years, and for children at higher risk of lipid disorders ages: 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years

·        Fluoride chemoprevention supplements for children without fluoride in their water source

·        Fluoride varnish for all infants and children as soon as teeth are present

·        Gonorrhea preventive medication for the eyes of all newborns

·        Hearing screening for all newborns; and for children once between 11 and 14 years, once between 15 and 17 years, and once between 18 and 21 years

·        Height, weight and body mass index (BMI) measurements for children ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years

·        Hematocrit or hemoglobin screening for all children

·        Hemoglobinopathies or sickle cell screening for newborns

·        Hepatitis B screening for adolescents at high risk, including adolescents from countries with 2% or more Hepatitis B prevalence, and U.S.-born adolescents not vaccinated as infants and with at least one parent born in a region with 8% or more Hepatitis B prevalence: 11–17 years

·        HIV screening for adolescents at higher risk

·        Hypothyroidism screening for newborns

·        Immunization vaccines for children from birth to age 18 — doses, recommended ages, and recommended populations vary:

·        Diphtheria, Tetanus, Pertussis (Whooping Cough)

·        Haemophilus influenza type b

·        Hepatitis A

·        Hepatitis B

·        Human Papillomavirus (HPV)

·        Inactivated Poliovirus

·        Influenza (flu shot)

·        Measles

·        Meningococcal

·        Pneumococcal

·        Rotavirus

·        Varicella (Chickenpox)

·        Iron supplements for children ages 6 to 12 months at risk for anemia

·        Lead screening for children at risk of exposure

·        Maternal depression screening for mothers of infants at 1, 2, 4, and 6-month visits

·        Medical history for all children throughout development ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years

·        Obesity screening and counseling

·        Oral health risk assessment for young children ages: 0 to 11 months, 1 to 4 years, 5 to 10 years

·        Phenylketonuria (PKU) screening for newborns

·        Sexually transmitted infection (STI) prevention counseling and screening for adolescents at higher risk

·        Tuberculin testing for children at higher risk of tuberculosis ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years

·        Vision screening for all children

BACK