What services are 100% covered as Preventive Care?
The Preventive Care covered services are determined by the participant’s age and gender. For the following preventive services, the deductible does not apply and any visit limits or maximums are combined for network and non-network care: Well-child care at the following age intervals: up to 1 year of age – seven visits; between 1 and 2 years of age – two visits. Routine physical examinations at the following age intervals: between 2 and up to 18 years of age – one visit per calendar year; from age 18 to 65 – one visit every two calendar years; age 65 or older – one visit per calendar year. Note: A routine physical examination includes a complete history and physical with associated X-ray and laboratory services according to generally accepted medical guidelines. Immunizations for children up to age 18 – covered in accordance with generally accepted medical guidelines. Immunizations for adults age 18 and over who are considered “at risk” for certain medical conditions such as influenza,
