Preventive Care. This plan covers preventive care as described below. “
Preventive Care. Drugs to treat infertility, to enhance fertility or to treat sexual dysfunction Weight management drugs or drugs for the treatment of obesity Replacement of lost or stolen medication
Preventive Care. Group shall have sole responsibility for --------------- all preventive care intended to delay, or intercept the development of pathologic conditions.
Preventive Care. Preventive care means: Evidence based items or services that are rated “A” or “B” in the current recommendations of the United States Preventive Services task Force with respect to the Member; Immunizations for routine use for Members of all ages as recommended by the Advisory Committee on Immunization Practices of the Centers of Disease Control and Prevention with respect to the Member; Evidence–informed preventive care and screenings for Members who are infants, children and adolescents, as included in the comprehensive guidelines supported by the Health Resources and Services Administration; Evidence–informed preventive care and screenings for female Members as included in the comprehensive guidelines supported by the Health Resources and Services Administration; and Any other evidence-based or evidence-informed items as determined by federal and/or state law. Examples of preventive care include, but are not limited to: routine physical examinations, including related laboratory tests and x-rays, immunizations and vaccines, well baby care, pap smears, mammography, screening tests, bone density tests, colorectal cancer screening, and Nicotine Dependence Treatment.
Preventive Care. To the extent required by PPACA, preventive care (with no cost-sharing) when preventive care is provided by Participating Providers.
Preventive Care. The Plan does not provide Benefits for preventive care and well-care services, unless otherwise stated in this Agreement in Sections 4.B and 2.
Preventive Care. Preventive care means care and services to avert disease/illness and/or its consequences. There are three (3) levels of preventive care: 1) primary, such as immunizations, aimed at preventing disease; 2) secondary, such as disease screening programs aimed at early detection of disease; and 3) tertiary, such as physical therapy, aimed at restoring function after the disease has occurred. Commonly, the term "preventive care" is used to designate prevention and early detection programs rather than restorative programs. The following preventive services are also included in the managed care Benefit Package. These preventive services are essential for promoting wellness and preventing illness. MCOs must offer the following: - General health education classes. - Pneumonia and influenza immunizations for at risk populations. - Smoking cessation classes, with targeted outreach for adolescents and pregnant women. - Childbirth education classes. - Parenting classes covering topics such as bathing, feeding, injury prevention, sleeping, illness prevention, steps to follow in an emergency, growth and development, discipline, signs of illness, etc.
Preventive Care. Pediatric No Copay No Copay No Copay Deductible Waived-No Copay Age based schedule 7 exams Birth to One 7 exams Birth to One 7 exams Birth to One 7 exams Birth to One 7 exams 1-5 years 7 exams 1-5 years 7 exams 1-5 years 7 exams 1-5 years 5 -22 years-Preventative exams allowed once a year 5 -22 years-Preventative exams allowed once a year 5 -22 years-Preventative exams allowed once a year 5 -22 years-Preventative exams allowed once a year Adult No Copay No Copay No Copay Deductible Waived-No Copay Age Based Schedule 22 and over-Preventative exams allowed once a year 22 and over-Preventative exams allowed once a year 22 and over-Preventative exams allowed once a year 22 and over- Preventative exams allowed once a year Immunizations As part of Preventative Exam As part of Preventative Exam As part of Preventative Exam As part of Preventative Exam Gynelogical/Obstetrics $0 Copay for annual exam $0 Copay for annual exam $0 Copay for annual exam Deductible waived-$0 Copay for annual exam $25 Copay Maternity-First Visit Only $25 Copay Maternity-First Visit Only $20 Copay Maternity-First Visit Only After deductable 80% In Network Mammography Age 35-39 Base Line Screening Age 35-39 Base Line Screening Age 35-39 Base Line Screening Age 35-39 Base Line Screening 40 and over once a year 40 and over once a year 40 and over once a year 40 and over once a year (Add'l Exams Available if Recommended by Doctor) (Add'l Exams Available if Recommended by Doctor) (Add'l Exams Available if Recommended by Doctor) (Add'l Exams Available if Recommended by Doctor) Hearing No Copay (once every 2 calendar years) No Copay (once every 2 calendar years) $0 Copay (once a every 2 years) No Copay (once every 2 calendar years) Deductible Waived Vision No Copay (once every 2 calendar years) No Copay (once every 2 calendar years) $0 Copay (once a every 2 years) No Copay (once every 2 calendar years) Deductible Waived MEDICAL SERVICES Medical office visits $15 Copay PCP $15 Copay PCP $20 Copay After Deductible 80% Co-Insurance in $25 Specialist $25 Specialist Unlimited Visits network 60% Out of Network Physical or Occupational $25 Copay $25 Copay $20 Copay After Deductible 80% Co-Insurance in network 60% out of network Therapy 30 Combined Visits for pt, ot st per member per year 30 Combined Visits for pt, ot st per member per year 30 Combined Visits for pt, ot st per member per year 60 Combined Visits for pt, ot st per member per year 20 visit for chiro-prior auth is required on pt/ot 20 visit...
Preventive Care. Preventive Care services include outpatient services and office services. Screenings and other services are covered as Preventive Care for adults and children with no current symptoms or prior history of a medical condition associated with that screening or service. Members who have current symptoms or have been diagnosed with a medical condition are not considered to require preventive care for that condition but instead benefits will be considered under the diagnostic services benefit. In-Network Preventive care services in this section shall meet requirements as determined by federal and state law. Many preventive care services are covered by your policy with no Deductible, Copayments or Coinsurance from the Member when provided by an In-Network Provider. That means Alliant pays 100% of the allowed amount. These services fall under four broad categories as shown below:
Preventive Care. Pediatric No Copay No Copay Adult No Copay No Copay Vision No Copay No Copay Covered once every 24 months Covered once every 24 months Hearing No Copay No Copay Screening part of physical exam Screening part of physical exam Gynecological No Copay No Copay Medical Services Medical Office Visit Copay Copay Outpatient PT/OT/ST/Chiro. Copay Copay 60 Combined Days 60 Combined Days per calendar year per member per calendar year per member Allergy Services office visits and testing; Copay office visits and testing; Copay No copay for injections No copay for injections Diagnostic Lab & X-ray Covered Covered Inpatient Medical Services Covered Covered Surgery Fees Covered Covered Office Surgery Covered Covered Outpatient MH/SA Copay based on date of service Copay based on date of service Emergency Care Emergency Room $75 Copay (waived if admitted) $75 Copay (waived if admitted) Sudden & Serious Guidelines Sudden & Serious Guidelines Urgent Care $25 Copay $25 Copay Ambulance Covered Covered APPENDIX C Town of Manchester, Connecticut BENEFIT OAP Plus OAP Basic Inpatient Hospital General/Medical/Surgical/ Pre-cert only for Out-of-Network Maternity (Semi-private) $200 Copay Effective 7/1/2017 $200 Copay Effective 7/1/2017 Ancillary Services Covered Covered Medication, Supplies Psychiatric Unlimited days Unlimited days Substance Abuse/Detox Unlimited days Unlimited days Skilled Nursing/Rehabilitation Covered up to 180 days per calendar year Covered up to 180 days per calendar year Facility Hospice Covered Covered Outpatient Hospital Outpatient Surgery Facility Charges $100 Copay $100 Copay (Prior Authorization Required) (Prior Authorization Required) Diagnostic Lab & X-ray Covered Covered Pre-Admission Testing Covered Covered Other Services Durable Medical Equipment Covered Covered Prosthetics Covered Covered Home Health Care Unlimited days Unlimited days (Prior Authorization Required) (Prior Authorization Required) Pharmacy Benefits Prescriptions $5/$20/$35 $5/$20/$35 Unlimited maximum Unlimited maximum Three Tier Formulary RX Rider Three Tier Formulary RX Rider All Benefits listed are for In-Network. For Out-of-Network benefits, please refer to your Employee Benefit Summary. INFERTILITY: Coverage is subject to a $5,000 lifetime maximum for the OAP Plus and OAP Basic plans. ELIGIBILITY: Dependent children covered to age 26 for medical and prescription plans. APPENDIX C Town of Manchester, Connecticut BENEFIT High Deductible Health Plan/ BENEFIT High Deductible Health P...
