Preventive Screenings Can Save Your Life
Which screenings do you need?
Many serious illnesses have no signs in the early stages. It’s important to talk to your doctor about screenings even if you feel fine. Age, health, and family history determine which screenings you need. Check with your doctor to see which screenings are right for you.
2024 & 2025 preventive health chart
The quick-reference chart below lists screenings your plan covers in 2024 and 2025. It is not a recommendation for how often to have a screening. Please talk to your doctor about what screenings are right for you. For more complete benefit information, see your Evidence of Coverage (EOC) booklet.
Annual Physical | |||||
| Explanations | Your coverage | Copay (HMO) | Copay (PPO In Network) | Copay (PPO Out of Network) | |
| Physical Exam | A checkup given by your doctor to help you stay healthy and identify any health issues before they become serious. | Once every calendar year. | $01 | $01 | 2024: 40% coinsurance 2025: $0 |
| Annual Wellness Visit | A checkup given by your doctor to review your health status, lifestyle, daily activities, nutrition, and any stress you may have. | Once every calendar year. | $01 | $01 | 2024: 40% coinsurance 2025: $0 |
Cancer Screenings | |||||
| Explanations | Your coverage | Copay (HMO) | Copay (PPO In Network) | Copay (PPO Out of Network) | |
| Breast Cancer | A breast exam and mammogram (type of X-ray) to check for signs of breast cancer. | One mammogram every 12 months—clinical breast exam once every 24 months. | $0 | $0 | 2024: 40% coinsurance 2025: 45% coinsurance |
| Cervical Cancer | Pap test and pelvic exam to check for cervical, vaginal, and ovarian cancers. | Once every 24 months, or every 12 months if at high risk. | $0 | $0 | 2024: 40% coinsurance 2025: $0 |
| Colorectal Cancer | Tests to find colorectal cancer early and determine, based on risk, what treatment may work best. | Colonoscopy screening once every 24 months if at high risk—once every 10 years if not at high risk. | $0 | $0 | 2024: 40% coinsurance 2025: 45% coinsurance |
| Prostate Cancer | Prostate screening by digital rectal exam and prostate specific antigen (PSA) test. | Once every 12 months. | $0 | $0 | 2024: 40% coinsurance 2025: $0 |
Immunizations | |||||
| Explanations | Your coverage | Copay (HMO) | Copay (PPO In Network) | Copay (PPO Out of Network) | |
| Flu Shot | A shot to help prevent the flu (you need a flu shot for the current virus each year). | Once per flu season (fall or winter). | $0 | $0 | $0 |
| Pneumonia | A shot to prevent pneumonia. | As medically necessary. | $0 | $0 | $0 |
| Hepatitis B | A shot to prevent Hepatitis B. | As medically necessary. | $0 | $0 | $0 |
| COVID-19 | A shot to prevent COVID-19. | As medically necessary. | $0 | $0 | $0 |
Sensory Screenings | |||||
| Explanations | Your coverage | Copay (HMO) | Copay (PPO In Network) | Copay (PPO Out of Network) | |
| Routine Hearing Exam | Test to determine hearing ability. | Once a year. | $0 | $0 | 2024: $45 per visit 2025: $40 per visit |
| Routine Vision Exam | Test to determine sight. | Once a year. | $15 | $0 | 2024: $45 per visit 2025: $40 per visit |
| Glaucoma | Test to find glaucoma, a condition that causes gradual loss of sight without warning and often without symptoms. | Once every calendar year if you are at high risk for glaucoma. | $0 | $0 | 2024: $45 per visit 2025: $40 per visit |
Other Screenings | |||||
| Explanations | Your coverage | Copay (HMO) | Copay (PPO In Network) | Copay (PPO Out of Network) | |
| Cardiovascular Disease Testing | Blood tests for the detection of cardiovascular disease. | Once every 5 years. | $0 | $0 | 2024: 40% coinsurance 2025: $0 |
| Diabetes | Blood tests to see if you are at risk for diabetes. | Based on test results, up to 2 screenings every 12 months. | $0 | $0 | 2024: 40% coinsurance 2025: $0 |
| Osteoporosis | Bone mass measurement tests (such as a DEXA scan) to see if you are at risk for broken bones. | If at risk, once every 24 months or more often if medically necessary. | $0 | $0 | 2024: 40% coinsurance 2025: 45% coinsurance |
| Depression | Test to determine risk of depression. | Once every calendar year. | $0 | $0 | 2024: 40% coinsurance 2025: $0 |
| Abdominal Aortic Aneurysms | Ultrasound exam. | Once per lifetime if at risk. | $0 | $0 | 2024: 40% coinsurance 2025: 45% coinsurance |
| STIs | Test to check for sexually transmitted infections (STIs). | Once every 12 months, or more often if medically necessary. | $0 | $0 | 2024: 40% coinsurance 2025: $0 |
| HIV | Test to check for HIV. | Once every 12 months. | $0 | $0 | 2024: 40% coinsurance 2025: 45% coinsurance |
Benefit information may be different if you receive your benefits from a current or former employer.
1A copay may apply if you receive services that address a medical condition during an annual physical or Annual Wellness Visit.