Acom Benefit Guide - Class 2 - Eligible Employees: Bi-Weekly

Preventative Health Care

Women preventive services (includes pregnant women) Preventive office visits are covered, as well as the screenings and counseling listed below. Screenings Anemia

Counseling Genetic counseling for women who have tested positive for BRCA Breast cancer chemoprevention Counseling for women at increased risk for breast cancer 1 Domestic and interpersonal violence Screening and referral for intervention services Healthy weight and weight gain Behavioral counseling interventions to promote healthy weight in pregnancy Tobacco smoking cessation Behavioral interventions and expanded counseling for pregnant tobacco users Perinatal depression Counseling interventions for pregnant and postpartum women at increased risk 1

Screening on a routine basis for pregnant women Urinary tract or other infection screening for pregnant women

Bacteriuria

BRCA

Screening for women at higher risk 1

Breast cancer mammography Cervical cancer

Screening every 1–2 years for women aged 40 or over

Screening for women with a cervix, regardless of sexual history, at specified ages and intervals 4 Screening for younger women and other women at higher risk 1 Screening for pregnant and postpartum women Screening for women after 24 weeks of gestation

Chlamydia infection

Depression

Gestational diabetes

Gonorrhea Hepatitis B

Screening for all women at higher risk 1 Screening for all pregnant women Screening for all pregnant women

HIV

HPV-DNA test

High risk testing every 3 years for women with normal cytology results who are aged 30 or older 1 Screening for women aged 65 and over and women at higher risk 1

Osteoporosis (bone density) Preeclampsia

Screening for all pregnant women

Rh(D) incompatibility

Blood typing/antibody testing for all pregnant women at the first prenatal visit and at 24–28 weeks’ gestation

Other services Breastfeeding 3

Syphilis

Screening for all pregnant women

Equipment and counseling to promote breastfeeding during pregnancy and in the postpartum period Contraceptive methods and counseling 3

Medications and supplements (covered with a doctor’s prescription) Aspirin to prevent preeclampsia Low-dose aspirin after 12 weeks of gestation in women at high risk 1 Breast cancer preventive medications For women at increased risk for breast cancer 1 Contraception FDA-approved contraceptives for women with reproductive capacity to prevent pregnancy

Prenatal vitamins/ folic acid

For women who are pregnant, may become pregnant or are capable of pregnancy

14 Acom Integrated Solutions 2022 Enrollment Guide 4 Women 21–65: with cytology (Pap test) every three years; women 30–65: wanting to lengthen the screening interval. We encourage you to seek any professional advice, including legal counsel, regarding how the new requirements will affect your specific plan. For complete details, refer to your plan’s Certificate of Coverage. 1 For more information on the definition of higher or increased risk and age recommendations, please see the US Preventive Guidelines at www.uspreventiveservicestaskforce.org/uspstf/recommendation-topics/uspstf-and-b-recommendations. 3 On Aug. 1, 2011, the U.S. Department of Health and Human Services released new guidelines regarding coverage of preventive health services for women. The new guidelines state that non-grandfathered insurance plans with plan years beginning on or after Aug. 1, 2012, must include these services without cost sharing.

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