Common use of Clinical Preventive Health Services Clause in Contracts

Clinical Preventive Health Services. This benefit has one or more exclusions as specified in the Exclusions Section. We will provide Coverage for Clinical Preventive Health Services without any Cost Sharing if you receive these services from our In-network Practitioners/Providers. If you receive these services from Out-of-network Practitioners/Providers you are responsible for the Out-of-network level Cost Sharing amounts. Refer to your Summary of Benefits and Coverage for Out-of-network Cost Sharing amounts. We will provide Coverage for preventive benefits, as defined by the Affordable Care Act (ACA), if you receive these services from our In-network Practitioners/Providers, without Cost Sharing regardless of sex assigned at birth, gender identity, or gender of the individual. Clinical Preventive Health Services Coverage is provided for services under four broad categories: • Screening and Counseling Services • Routine Immunizations • Childhood Preventive Services • Preventive Services for Women

Clinical Preventive Health Services. This benefit has one or more exclusions as specified in the Exclusions Section. We will provide Coverage for Clinical Preventive Health Services without any Cost Sharing if you receive these services from our In-network Practitioners/Providers. If you receive these services from Out-of-network Practitioners/Providers you are responsible for the Out-of-network level Cost Sharing amounts. Refer to your Summary of Benefits and Coverage for Out-of-network Cost Sharing amounts. We will provide Coverage for preventive benefits, as defined by the Affordable Care Act (ACA), if you receive these services from our In-network Practitioners/Providers, without Cost Sharing cost sharing regardless of sex assigned at birth, gender identity, or gender of the individual. Clinical Preventive Health Services Coverage is provided for services under four broad categories: • Screening and Counseling Services • Routine Immunizations • Adult Preventive Services • Childhood Preventive Services • Preventive Services for Women

Clinical Preventive Health Services. This benefit has one or more exclusions as specified in the Exclusions Section. We will provide Coverage for Clinical Preventive Health Services without any Cost Sharing if you receive these services from our In-network Practitioners/Providers. If you receive these services from Out-of-network Practitioners/Providers you are responsible for the Out-of-network level Cost Sharing amounts. Refer to your Summary of Benefits and Coverage for Out-of-network Cost Sharing amounts. We will provide Coverage for preventive benefits, as defined by the Affordable Care Act (ACA), if you receive these services from our In-network Practitioners/Providers, without Cost Sharing regardless of sex assigned at birth, gender identity, or gender of the individual. Clinical Preventive Health Services Coverage is provided for services under four broad categories: • Screening and Counseling Services • Routine Immunizations • Adult Preventive Services • Childhood Preventive Services • Preventive Services for Women

Clinical Preventive Health Services. This benefit has one or more exclusions as specified in the Exclusions Section. We will provide Coverage for Clinical Preventive Health Services without any Cost Sharing if you receive these services from our In-network Practitioners/Providers. If you receive these services from Out-of-network Practitioners/Providers you are responsible for the Out-of-network level Cost Sharing amounts. Refer to your Summary of Benefits and Coverage for Out-of-network Cost Sharing amounts. We will provide Coverage for preventive benefits, as defined by the Affordable Care Act (ACA), if you receive these services from our In-network Practitioners/Providers, without Cost Sharing cost sharing regardless of sex assigned at birth, gender identity, or gender of the individual. Clinical Preventive Health Services Coverage is provided for services under four broad categories: • Screening and Counseling Services • Routine Immunizations • Childhood Preventive Services • Preventive Services for Women

Clinical Preventive Health Services. This benefit has one or more exclusions as specified in the Exclusions Section. We will provide Coverage for Clinical Preventive Health Services without any Cost Sharing if you receive these services from our In-network Practitioners/Providers. If you receive these services from Out-of-network Practitioners/Providers you are responsible for the Out-of-of- network level Cost Sharing amounts. Refer to your Summary of Benefits and Coverage for Out-Out- of-network Cost Sharing amounts. We will provide Coverage for preventive benefits, as defined by the Affordable Care Act (ACA), if you receive these services from our In-network Practitioners/Providers, without Cost Sharing cost sharing regardless of sex assigned at birth, gender identity, or gender of the individual. Clinical Preventive Health Services Coverage is provided for services under four broad categories: • Screening and Counseling Services • Routine Immunizations • Adult Preventive Services • Childhood Preventive Services • Preventive Services for Women