Preventive Services
Essential Health Benefits
A holistic care approach focuses on wellness and prevention. At the heart of our preventive care is a promise that you’ll get the support needed to remain healthy and enjoy life. Prevea360 Health Plan provides the following preventive services with no copays, coinsurance or deductibles:* • Annual Preventive Office Visit, which includes important preventive services • Screenings for breast, cervical and colon cancer • Cholesterol screenings • Routine vaccinations for adults and children • And more services Visit prevea360.com/preventivecare or call the customer care center at 877-230-7555 (TTY:711) for a comprehensive list of covered preventive services.
Defined as the 10 categories of common benefits that are deemed essential,** these Essential Health Benefits cannot be subject to dollar limits, either annually or on a lifetime basis. Depending on the type of plan you purchased, services associated with Essential Health Benefits may still require cost sharing in the form of copays, coinsurance and deductibles. These include:
• Preventive*, wellness and disease management services • Emergency care • Hospitalization • Ambulatory care • Maternity and newborn services • Prescription drug coverage
• Pediatric services† • Laboratory services • Rehabilitative and habilitative services • Mental health and substance abuse services, including mental health treatment
Check out our glossary of common terms at prevea360.com/insuranceterms
* No cost share responsibilities apply when services are delivered by a network provider, and when all preventive services criteria are met Visit prevea360.com/preventivecare for a comprehensive list of covered preventive services. ** A ll small group plans (2–50 employees) cover Essential Health Benefits. However, if you work for a larger employer (51+ employees) your benefits may vary. Contact your human resources or benefits department for information about your specific coverage. † Prevea360 Health Plan does not offer pediatric dental services. This coverage is available on the Health Insurance Marketplace (healthcare.gov) and can be purchased as a stand-alone product. Please contact your benefits administrator or the Marketplace if you wish to purchase pediatric dental coverage or a stand-alone dental services product.
Visit prevea360.com or call 877-230-7555 |
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