8/4/2019 Harvard Pilgrim Preventive Care List

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Preventive care:good for your well-being

andyour wallet

Harvard Pilgrim is committed to helping

you be as healthy as you can be. And one

o the best ways to do that is to take advantage

o your plans preventive care benefts.

In addition to receiving care that can help identiy

health risks, a preventive care visit gives you a great

opportunity to talk to your doctor. For instance,

you can ask questions about liestyle choices, stress,

nutrition, or getting enough exercise and sleep.

Staying healthy also means more dollars stay in your pocket, because youll

spend less on health care expenses. Plus, many preventive care services are

covered in ull under your Harvard Pilgrim plan.

See the reverse for a list of preventive care services that canhelp you live a healthier life.

Important Notes

The preventive care services listed may not apply to some group plans,including self-insured plans and plans that are grandfathered under theAffordable Care Act. Check with your employer to see if the services applyto your particular plan.

If eligible as noted above, you are not responsible for a copayment or othercost sharing for the preventive care services listed on the reverse.

Additional care provided as a follow-up to preventive care and other carereceived during a preventive care visit may not be covered in full.

This information refers to products and services offered by Harvard Pilgrim Health Care and its afliates,

Harvard Pilgrim Health Care of New England and HPHC Insurance Company.

8/4/2019 Harvard Pilgrim Preventive Care List

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Preventive care servicesThe preventive services and tests listed below are covered with no member cost sharingwhen received from a Harvard Pilgrim in-network (plan) provider.

Adults and Children

Routinephysicalexaminations

Alcoholmisusescreeningandcounseling(primarycarevisitsonly,beginningatage11)

Cholesterolscreening

Depressionscreening(adults,childrenages12-18,primarycarevisitsonly)

Dietbehavioralcounseling(includedaspartoannualvisitandintensivecounselingbyprimarycarecliniciansorbynutritionistsanddieticians)

HemoglobinA1c

HepatitisBtesting

Immunizations,includingushots

Obesityscreeningandcounseling(adultsandchildren,inprimarycaresettings)

Sexuallytransmitteddiseases(STDs)screeningsandcounseling(adolescents,adultsandpregnantwomen)

Tobaccousescreeningandcounseling(primarycarevisitsonly)

Totalcholesteroltests

Adults Only

Aspirinorthepreventionoheartdisease(primarycarecounselingonly)

Bloodpressurescreening(adultswithoutknownhypertension)

Colorectalcancerscreening,includingcolonoscopy,sigmoidoscopyandecaloccultbloodtest

Diabetesscreenings

HIVscreening

Women Only

Breastcancerchemoprevention(counselingonlyorwomenathighriskorbreastcancerandlowriskoradverseeectsochemoprevention)

Breastcancerscreening,includingmammogramsandcounselingorgeneticsusceptibilityscreening

Breasteedingprimarycareinterventions(applicabletopregnantwomenandnewmothers;includeslactationclassesandsupportatprenatalandpost-partumvisits,andnewbornvisits

Cervicalcancerscreening,includingpapsmears

Folicacidsupplements(womenplanningorcapable

opregnancyonly)Note:coverageorolicacidisonlyprovidediyourplanincludesoutpatientpharmacycoverage

Irondefciencyanemia(pregnantwomenatprenatalvisits)

Microalbuminuriatest(pregnantwomen)

Osteoporosisscreening(screeningtobeginatage60orwomenatincreasedrisk)

Ovariancancersusceptibilityscreening

Rh(D)incompatibility,screening(pregnantwomen)

RoutineOB/GYNexaminations

Routineoutpatientprenatalandpostpartumvisits

Men Only

Abdominalaorticaneurysmscreening(ormales65-75onetimeonly,ieversmoked)

Children Only

Autismscreening(orchildrenat18and24monthsoage;primarycaresettings)

Behavioralassessments(childrenoallages;developmentalsurveillance,inprimarycaresettings)

Congenitalhypothyroidism(screeningornewbornsonly)

Dentalcariesprevention-oraluoride(orchildrentoage5only)Note:Coverageoruorideisonlyprovidediyourplanincludesoutpatientpharmacycoverage

Dyslipidemiascreening(orchildrenathighriskorhigherlipidlevels)

Hearingscreening(screeningornewbornonly,primarycaresettings)

Irondefciencyprevention(primarycarecounselingorchildrenages6to12monthsonly)

Leadscreening(childrenatrisk)

Phenylketonuriascreening(newbornsbeore7daysold)

Sicklecelldisease,screening(screeningatbirthandfrstnewbornvisit)

Tuberculosisskintesting

Visionscreening(childrentoage5only)

For a wealth of information, tools and resources supporting your well-being,visit www.harvardpilgrim.org/wellness.