It’s a new school year—and a new plan year. The start of the school year brings back-to-school checkups, sports physicals and immunizations. A new plan year brings much of the same. If you haven’t made an appointment for yourself and your family to see your primary care provider (PCP) for a yearly checkup, now is a great time. Be sure to ask your doctor about any recommended preventive screenings or immunizations.
What is preventive care?
Preventive care is health care that has been proven to be safe and effective in preventing disease. It can also help find health problems early, when they can be treated most effectively. Additionally, routine preventive care may help you save money by helping you avoid costly health care services in the future.
Some forms of preventive care are age- and gender-specific. These may include routine checkups, screenings and even vaccinations. Your health care provider can help you decide which screenings are right for you. Based on your age and gender, your doctor might suggest screenings for conditions including diabetes, high cholesterol, prostate cancer (men) and cervical and breast cancer (women). Health experts recommend vaccinations to prevent common illnesses that are easily spread, like the flu, chicken pox, shingles, measles and pneumonia. Check with your PCP to see which vaccinations are right for you.
How to know what is covered as preventive care
The HealthSelect of Texas and Consumer Directed HealthSelect plans cover most routine preventive care at 100% when received from an in-network provider, depending on how the provider codes the service and any diagnoses. This means you should pay nothing out of pocket. You can find more details about covered preventive screenings and immunizations for adults
. Click on the link to Publications and Forms on the left-hand menu.
Call a BCBSTX Personal Health Assistant today
You can always call a Blue Cross and Blue Shield of Texas (BCBSTX) Personal Health Assistant (PHA) with any questions about your health plan and benefits. A PHA is trained to help you and your covered family members make the best use of your health plan—and may even help you save money.
For example, if you don’t already have a PCP, a PHA can help you find one and even help set up your initial appointment. PHA’s can also give you information about benefits, wellness programs and other resources available under your health plan, including information about topics such as disease management, wellness and weight loss programs, and useful web and mobile tools.
Call a BCBSTX Personal Health Assistant toll-free at (800) 252-8039,
Monday-Friday 7 a.m. to 7 p.m. and Saturday 7 a.m. to 3 p.m. CT.
Both Community First Health Plans
and Scott and White Health Plan
also cover preventive health services at 100% when provided by an in-network provider. Services include routine checkups, recommended screenings and even vaccinations.
If you have any questions about preventive care coverage under your health plan, call:
- Community First Health Plans' Member Services at (210) 358-6262 or toll-free at (877) 698-7032, Monday - Friday, 8:30 a.m. - 5 p.m., CT.
- Scott and White Health Plan’s Customer Service line, toll-free at (800) 321-7947, Monday-Friday, 7 a.m. - 7 p.m. CT.