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Preventive Care Services at No Additional Cost

The Patient Protection and Affordable Care Act requires all health plans, except grandfathered1 plans, to provide coverage for preventive care services at no additional cost. These are provided to help prevent diseases or injuries, rather than to diagnose or treat a symptom or complaint, or to treat or cure a disease. These services include women’s preventive care and are based on recommendations from the Advisory Committee on Immunization Practices, the U.S. Preventive Services Task Force, Bright Futures, the American Academy of Pediatrics, and the U.S. Department of Health and Human Services. When provided by in-network providers, members do not pay additional costs for these services2. However, members with plans that include out-of-network or self-referred level of benefits (for example, PPO and Blue Choice plans) will pay a cost share when these services are obtained from an out-of-network provider.

Blue Cross Blue Shield of Massachusetts offers the following services at no additional cost when administered by network providers3:

Routine adult exams4 

Routine GYN exams4

Certain family planning services 

Routine hearing exams

Routine vision exams4

Certain prenatal services

Routine pediatric exams 

Physical therapy to prevent falls in community-dwelling adults ages 65 and older4

Routine tests, procedures, and screenings

Certain counseling services

Immunizations 

Certain pharmacy services

Women’s preventive health services recommended by the Department of Health and Human Services include the following3: 

Annual well-woman visits 

Screening for gestational diabetes

Human papillomavirus (HPV) DNA testing

Counseling for sexually transmitted infections

Counseling and screening for human immunodeficiency virus (HIV) infections

Contraceptive methods and counseling

Breastfeeding support, supplies, and counseling

Domestic violence screening

Blue Cross Blue Shield of Massachusetts offers the following services at no additional cost when administered by network providers3:

Routine adult exams4 

Routine GYN exams4

Certain family planning services 

Routine hearing exams

Routine vision exams4

Certain prenatal services

Routine pediatric exams 

Physical therapy to prevent falls in community-dwelling adults ages 65 and older4

Routine tests, procedures, and screenings

Certain counseling services

Immunizations 

Certain pharmacy services

 

Women’s preventive health services recommended by the Department of Health and Human Services include the following3: 

Annual well-woman visits 

Screening for gestational diabetes

Human papillomavirus (HPV) DNA testing

Counseling for sexually transmitted infections

Counseling and screening for human immunodeficiency virus (HIV) infections

Contraceptive methods and counseling

Breastfeeding support, supplies, and counseling

Domestic violence screening

Preventive Services at No Additional Cost

We cover the preventive services listed in the following charts at no additional cost to our members when the services are obtained from an in-network provider. Some of these services may also be covered as part of routine physical exams, such as checkups, routine gynecological visits, or well-child exams.

For Adults, Including Women’s Preventive Services (Age 19 and Older)5

Screenings, Tests, and Procedures Counseling Services Pharmacy Services,6 Immunizations,7 and Supplies

Blood pressure

Depression

Cholesterol

Colorectal cancer

Diabetes in asymptomatic adults

Gonorrhea

Hepatitis B

Hepatitis C

Tuberculosis

HIV

Syphilis

Lung cancer screening for adults age 55 to 80 who have a 30-pack-per-year smoking history and currently smoke or have quit within the past 15 years

Dyslipidemia screening

Males:

Abdominal aortic aneurysm, for males 65–75 (once per lifetime)

Females:

Breast cancer mammography (at least one baseline mammogram between ages 35-39 and one mammogram per calendar year for a member age 40 or older) 

Cervical cancer, including Pap smears (one per calendar year)

Chlamydial infection 

Osteoporosis, for women age 60 and older, and for women under age 60 who are at increased risk (one per calendar year)

Domestic violence8

Voluntary sterilization procedures8

HPV DNA testing

Breast cancer susceptibility gene (BRCA) testing

Prenatal:

Bacteriuria (pregnant women at 12 weeks or first prenatal visit)

Rh incompatibility

Screening for gestational diabetes8

Preeclampsia screening

Iron deficiency anemia screening

Aspirin for the prevention of heart disease

Breast cancer chemoprevention

Breast cancer screening

Breastfeeding

Alcohol misuse (includes screenings)

Sexually transmitted infections8

Tobacco use (includes screenings)

Obesity (includes screenings)

Healthy diet for hyperlipidemia and risk for diet-related chronic disease

HIV8

Contraceptive methods8

Skin cancer 

Intensive behavioral counseling for obese adults with cardiovascular disease (CVD)risk factors

Pharmacy Services:

Generic low-to-moderate dose statin medication for adults ages 40–75 years with no history of CVD, one or more CVD risk factors, and a calculated 10-year CVD event risk of 10% or greater

Folic acid supplements through age 50

Generic birth control drugs and methods (or for a brand-name drug or method when a generic is not available)

Risk-reducing medications for those at increased risk of breast cancer

Bowel preparations

Immunizations: 7

Hepatitis A 

Hepatitis B 

Herpes zoster 

HPV 

Influenza 

Measles, mumps, rubella 

Meningococcal 

Pneumococcal 

Tetanus, diphtheria, pertussis 

Varicella

Rabies

Travel immunizations

Supplies:

Breastfeeding support and breast pumps8

(Check your benefit materials for more information.)

Over-the-Counter Medications6:

Generic aspirin (81mg) 

Generic folic acid up to age 50

Generic smoking cessation (up to two 90-day supplies per calendar year)

Generic vitamin D age 65 and older

Generic contraceptives (e.g., female condoms, sponges, emergency contraceptives, and spermicide) 

Bowel preparations

Screenings, Tests, and Procedures

Blood pressure

Depression

Cholesterol

Colorectal cancer

Diabetes in asymptomatic adults

Gonorrhea

Hepatitis B

Hepatitis C

Tuberculosis

HIV

Syphilis

Lung cancer screening for adults age 55 to 80 who have a 30-pack-per-year smoking history and currently smoke or have quit within the past 15 years

Dyslipidemia screening

Males:

Abdominal aortic aneurysm, for males 65–75 (once per lifetime)

Females:

Breast cancer mammography (at least one baseline mammogram between ages 35-39 and one mammogram per calendar year for a member age 40 or older) 

Cervical cancer, including Pap smears (one per calendar year)

Chlamydial infection 

Osteoporosis, for women age 60 and older, and for women under age 60 who are at increased risk (one per calendar year)

Domestic violence8

Voluntary sterilization procedures8

HPV DNA testing

Breast cancer susceptibility gene (BRCA) testing

Prenatal:

Bacteriuria (pregnant women at 12 weeks or first prenatal visit)

Rh incompatibility

Screening for gestational diabetes8

Preeclampsia screening

Iron deficiency anemia screening

Counseling Services

Aspirin for the prevention of heart disease

Breast cancer chemoprevention

Breast cancer screening

Breastfeeding

Alcohol misuse (includes screenings)

Sexually transmitted infections8

Tobacco use (includes screenings)

Obesity (includes screenings)

Healthy diet for hyperlipidemia and risk for diet-related chronic disease

HIV8

Contraceptive methods8

Skin cancer 

Intensive behavioral counseling for obese adults with cardiovascular disease (CVD)risk factors

Pharmacy Services,6 Immunizations,7 and Supplies

Pharmacy Services:

Generic low-to-moderate dose statin medication for adults ages 40–75 years with no history of CVD, one or more CVD risk factors, and a calculated 10-year CVD event risk of 10% or greater

Folic acid supplements through age 50

Generic birth control drugs and methods (or for a brand-name drug or method when a generic is not available)

Risk-reducing medications for those at increased risk of breast cancer

Bowel preparations

Immunizations: 7

Hepatitis A 

Hepatitis B 

Herpes zoster 

HPV 

Influenza 

Measles, mumps, rubella 

Meningococcal 

Pneumococcal 

Tetanus, diphtheria, pertussis 

Varicella

Rabies

Travel immunizations

Supplies:

Breastfeeding support and breast pumps8

(Check your benefit materials for more information.)

Over-the-Counter Medications6:

Generic aspirin (81mg) 

Generic folic acid up to age 50

Generic smoking cessation (up to two 90-day supplies per calendar year)

Generic vitamin D age 65 and older

Generic contraceptives (e.g., female condoms, sponges, emergency contraceptives, and spermicide) 

Bowel preparations

For Children (Birth Through 18 Years)

Screenings, Tests, and Counseling Services Pharmacy Services9 Immunizations10

Obesity screening, behavioral interventions, and counseling

Phenylketonuria

Lead

Developmental screening

Autism screening

Developmental surveillance

Psychosocial and behavioral assessment

Alcohol and drug use assessment

Dyslipidemia

Cervical dysplasia

Tuberculin test

Hematocrit or hemoglobin

Sexually transmitted diseases

HIV screening (for adolescents at risk)

Visual acuity screening

Vision screening/assessment 

Oral health risk assessment

Tobacco counseling and cessation interventions

Newborns:

Hearing loss (up to one year old)

Congenital hypothyroidism

Sickle cell disease 

Metabolic and hemoglobin

Adolescents:

Depression (ages 12–18)

Dental cavities chemoprevention, oral fluoride (up through age 16)

Iron supplements for infants (up to 12 months old)

Prophylactic eye medication for gonorrhea for infants (up to 12 months old) 

Generic over-the-counter iron supplements for infants (up to 12 months old)

Ages 0–18:

Diphtheria, tetanus, pertussis 

Hepatitis A 

Hepatitis B 

Inactivated poliovirus 

Influenza 

Measles, mumps, rubella 

Meningococcal 

Pneumococcal 

Rotavirus 

Varicella (chickenpox)

Ages 0–4:

Haemophilus influenzae type B 

Ages 11 and Older:

HPV

Screenings, Tests, and Counseling Services

Obesity screening, behavioral interventions, and counseling

Phenylketonuria

Lead

Developmental screening

Autism screening

Developmental surveillance

Psychosocial and behavioral assessment

Alcohol and drug use assessment

Dyslipidemia

Cervical dysplasia

Tuberculin test

Hematocrit or hemoglobin

Sexually transmitted diseases

HIV screening (for adolescents at risk)

Visual acuity screening

Vision screening/assessment 

Oral health risk assessment

Tobacco counseling and cessation interventions

Newborns:

Hearing loss (up to one year old)

Congenital hypothyroidism

Sickle cell disease 

Metabolic and hemoglobin

Adolescents:

Depression (ages 12–18)

Pharmacy Services9

Dental cavities chemoprevention, oral fluoride (up through age 16)

Iron supplements for infants (up to 12 months old)

Prophylactic eye medication for gonorrhea for infants (up to 12 months old) 

Generic over-the-counter iron supplements for infants (up to 12 months old)

Immunizations10

Ages 0–18:

Diphtheria, tetanus, pertussis 

Hepatitis A 

Hepatitis B 

Inactivated poliovirus 

Influenza 

Measles, mumps, rubella 

Meningococcal 

Pneumococcal 

Rotavirus 

Varicella (chickenpox)

Ages 0–4:

Haemophilus influenzae type B 

Ages 11 and Older:

HPV

1. Exempt from certain rights and protections provided under the Affordable Care Act

2. In-network (PPO plans) or PCP/plan approved benefits (Blue Choice plans)

3. The list of preventive care services and tests covered with no member cost share is subject to change upon the issuance of additional guidance from the federal government pursuant to the Patient Protection and Affordable Care Act. Blue Cross Blue Shield of Massachusetts has updated its products, and certain plan designs may have expanded preventive benefits beyond what is required by the Affordable Care Act. Some grandfathered or self-insured plan designs may have a more limited selection.

4. Certain limitations may apply. For a complete description of benefits, please refer to your subscriber certificate, account agreement description, or plan materials.

5. This list is subject to change at any time.

6. A licensed clinician must prescribe these medications.

7. Doses, recommended ages, and recommended populations vary.

8. These services are included in the Women’s Preventive Health Services.

9. A licensed clinician must prescribe these medications.

10. Doses, recommended ages, and recommended populations vary.

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ការជូនដំណឹង៖ ប្រសិនប. ើអ្នកនិយាយភាសា ខ្មែរ សេ  វាជំនួយភាសាឥតគិតថ្លៃ គឺអាចរកបានសម្  រាប ់អ្នក។ សូមទូរស័ព្ទទ ៅផ ្នែ កសេ  វាសមា  ជិកតាមល េខន  ៅល.  ើប ័ណ្ណ សម្  គាល ់ខ្លួ ខ្លួ នរប ស់អ្នក ហៅ  1-800-472-2689 (TTY: 711) ។

ATTENZIONE: se parlate italiano, sono disponibili per voi servizi gratuiti di assistenza linguistica. Chiamate il Servizio per i membri al numero riportato sulla vostra scheda identificativa chiamata  1-800-472-2689 (TTY: 711 ).

참고 : 한국어를 사용하는 경우 언어 지원 서비스를 무료로 사용할 수 있습니다. 신분증에있는 전화 번호 1-800-472-2689 (TTY : 711)로 회원 서비스에 연락하십시오.

ΠΡΟΣΟΧΗ: Εάν μιλάτε Ελληνικά, διατίθενται για σας υπηρεσίες γλωσσικής βοήθειας, δωρεάν. Καλέστε την Υπηρεσία Εξυπηρέτησης Μελών στον αριθμό της κάρτας μέλους σας (ID Card) κλήση 1-800-472-2689 (TTY: 711 ).

UWAGA: Osoby posługujące się językiem polskim mogą bezpłatnie skorzystać z pomocy językowej. Należy zadzwonić do Działu obsługi ubezpieczonych pod numer podany na identyfikatorze zadzwoń 1-800-472-2689 (TTY: 711 ).

ध्यान दें: य दि  आप ह िन् दी बोलते ह ैं, तो भा षा  सहाय  ता  सेवा एँ, आप के लि ए नि :शुल्क  उपलब्ध ह ैं। सदस्य  सेवा ओं को आपके आई.डी. कार  ्ड पर दि ए गए नंबर पर कॉल करें  कॉल 1-800-472-2689 ( टी .टी .वा ई.: 711).

ધ્યાન આપો:  જો તમે ગુજરા તી બોલતા  હો, તો તમને ભા ષા કીય  સહાય  તા  સેવા ઓ વિ ના  મૂલ્યે  ઉપલબ્ધ છે. તમા રા  આઈડી કાર  ્ડ પર આપેલા  નંબર પર Member Service  ને કૉલ કરો કૉલ કરો 1-800-472-2689 (TTY: 711).

PAUNAWA: Kung nagsasalita ka ng wikang Tagalog, mayroon kang magagamit na mga libreng serbisyo para sa tulong sa wika. Tawagan ang Mga Serbisyo sa Miyembro sa numerong nasa iyong ID Card tumawag 1-800-472-2689 (TTY: 711 ).

お知らせ:日本語をお話しになる方は無料の言語アシスタンスサービスをご利用いただけます。ID カードに記載の電話番号を使用してメンバーサービスまでお電話ください 呼び出す 1-800-472-2689(TTY: 711 )。

ACHTUNG: Wenn Sie Deutsche sprechen, steht Ihnen kostenlos fremdsprachliche Unterstützung zur Verfügung. Rufen Sie den Mitgliederdienst unter der Nummer auf Ihrer ID-Karte an Anrufen 1-800-472-2689 (TTY: 711 ).

ATTENTION: If you speak a language other than English, language assistance services are available to you free of charge. Call 1-800-472-2689 (TTY: 711).

ຂໍ້ຄວນໃສ່ໃຈ: ຖ້າເຈົ້າເວົ້າພາສາລາວໄດ້, ມີການບໍລິການຊ່ວຍເຫຼືອດ້ານພາສາໃຫ້ທ່ານໂດຍບໍ່ເສຍຄ່າ. ໂທ ຫາ ຝ່າຍບໍລິການສະ ມາ ຊິກທີ່ໝາຍເລກໂທລະສັບຢູ່ໃນບັດຂອງທ່ານ ໂທ 1-800-472-2689 (TTY: 711).

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