Well Child Care. With respect to infants, children, and adolescents, evidence-informed preventive care and screenings provided for in the comprehensive guidelines supported by the Health Resources and Services Administration.
Well Child Care. Charges incurred by a Covered Person from newborn to seventeen (17) years of age for services rendered solely for the purpose of health maintenance and not for the Treatment of an Illness or Injury. Payment, for such Services shall be based on the Bright Futures/American Academy of Pediatrics recommendations for Preventive Pediatric health Care and as stated in Exhibit . Benefits for such services may include immunization and lab tests. Services must be performed by or under the supervision of a Physician. Well Child Care will not be subject to the deductible, and shall be covered at 100% by the Company. Any such care that is PPACA Preventive Care Services shall be covered without Deductibles, Co-Payments or Co-Insurance if received from a Participating Provider. Charges for treatment of illness or injury shall be covered as regular benefits. If the care is PPACA Preventive Care Services, requirements of this agreement and PPACA regulations shall be followed in determining the portion of any combined visit or service that is to be provided without Deductibles, Co-Payments or Co- Insurance
Well Child Care. Well Child Care is covered only as set forth in §2.7 and as required by PPACA (as a PPACA Preventive Care Services or otherwise).
Well Child Care. No Copayment Deductible & Coinsurance 7 exams from birth to 1 year 7 exams 1 through 5 years of age 1 exam every year from 5 through 11 years 1 exam every year from 11 through 22 years 1 exam every year 22+ Adult Physical Examinations No Copayment Deductible & Coinsurance Periodic, routine health examinations 1 exam every year 22+ Routine Gynecological Visit No Copayment Deductible & Coinsurance 1 visit per Calendar Year including pap smear Mammography No Charge Deductible & Coinsurance One baseline screening for female 35 through 39 years of age One screening mammogram every Calendar Year for female 40 and older Note: or more frequently if recommended by the woman’s Physician (M.D.) Vision Exams No Copayment Deductible & Coinsurance Calendar Year Hearing Exams No Copayment: Confirmed PPACA coverage. Additional exam cove age for those who don’t qualify for PPACA coverage Deductible & Coinsurance 1 hearing exam every 2 Calendar Years Immunizations and No Copayment Deductible & Coinsurance Vaccinations includes those needed for travel MEDICAL CARE Medical Office Visit Primary care office visits Specialist consultations OB/GYN care $20 Copayment Deductible & Coinsurance Maternity Care $20 Copayment Deductible & Coinsurance Initial visit subject to Copayment, no charge thereafter Allergy Office Visit/Testing No Copayment Deductible & Coinsurance Allergy Injections Immunotherapy or other therapy treatments No Copayment for Allergy Deductible & Coinsurance unlimited Injection Calendar Year period Diagnostic, Laboratory and X-ray No Charge Deductible & Coinsurance Services High Cost Diagnostic Tests No Charge Deductible & Coinsurance MRI, MRA, CAT, CTA, PET and SPECT scans HOSPITAL CARE – Prior authorization required All Inpatient Admissions Semi- private room Maternity and newborn care $200 Copayment Deductible & Coinsurance Copayment is waived if readmitted within 30 days for same diagnosis Skilled Nursing Facility No Copayment Deductible & Coinsurance up to 120 days per Calendar Year Specialty Hospital (Rehabilitation) No Copayment Deductible & Coinsurance 60 days per Covered Person per Calendar Year Outpatient Surgery No Copayment Deductible & Coinsurance In a licensed ambulatory surgical center (including colonoscopy) EMERGENCY CARE Walk-in centers $20 Copayment Deductible & Coinsurance Urgent care – at participating centers $20 Copayment Paid as an In-Network Service Emergency Room Treatment Emergency Room Copayment waived if the Covered Person is admitted ...
Well Child Care. Charges for Well Child care for a Dependent child shall be paid in accordance with Affordable Care Act requirements.
Well Child Care. We will provide benefits for Well Child Care for covered children from the date of birth through attainment of age 19, when provided by your PCP. Well Child Care means an initial newborn check- up in the hospital and well child visits. Well child visits include a medical history, a complete physical examination, developmental assessment, anticipatory guidance, and laboratory tests ordered at the time of the visit. Such laboratory tests must be performed in the office or in a clinical laboratory. All well child visits must be provided in accordance with the standards and frequency schedule of the American Academy of Pediatrics. Well Child Care also includes immunizations against diphtheria, pertussis, tetanus, polio, measles, rubella, mumps, hemophilus influenza type B, and hepatitis B, and other necessary immunizations.
