Benefit Reference Guide - The School District of Palm Beach County

Healthcare Benefits - Preventative Care
Understanding preventive care
How can I determine what will be covered as a preventive
care service?
Certain services can be done for preventive or non-preventive (diagnostic) reasons. Generally
when a service is performed during your annual preventive care visit, specifically for preventive
screening, and there are no known symptoms, illnesses or history, the services will be considered
as preventive care 1 , subject to your benefit plan provisions.
Preventive services can include many types of exams, subject to age and gender
guidelines, including:
Physician office services:
` Routine physical examinations
` Well baby and well child care
` Immunizations
Lab, X-ray or other preventive screening tests:
` Screening mammography
` Screening colonoscopy or sigmoidoscopy
` Cervical cancer screening
` Prostate cancer screening
` Osteoporosis screening
Preventive Care: Routine annual screenings to “prevent” illness or injury.
Non-preventive care: If diagnosed with a condition, some screenings often considered part of treatment.
Be sure to talk to your doctor.
Preventive Care
Mammogram - annually for women starting at age
40, or recommendation
Colonoscopy - every 10 years starting at age 50,
recommendation
Annual physical/preventive care exam - includes
height, weight, blood pressure
Pap smear - once annually for women who are 18
year of age or older
Not Preventive Care
Patient found lump in breast and doctor recommends
mammogram to diagnose condition
Patient has unexplained weight loss and constipation.
Afraid it’s colon cancer; schedules colonoscopy
Office visit due to fever and rash
Abnormal Pap smear; returns for second exam. This
second exam would be considered non-preventive
For more information about preventive care services that might be
right for you visit www.uhcpreventivecare.com.
1
The content provided is for informational purposes only, and does not constitute medical advice. Always consult your doctor before making any decisions about medical
care. The services outlined here do not necessarily reflect the services, vaccine, screenings or tests that will be covered under your benefit plan. Always refer to your
plan documents for specific benefit coverage and limitations or call the toll-free member phone number on the back of your ID card. Certain procedures may not be fully
covered under some benefit plans.
www.myFBMC.com
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