Preventive Care

Many health conditions can be prevented or detected early by making healthy lifestyle choices such as eating nutritional foods, getting appropriate exercise, and visiting your doctor for preventive care. View the Preventive Health Guidelines and Benefits for Preventive Services below to see what screenings, immunizations and other preventive measures are recommended by the experts for your age group and gender. Use these guidelines to help maintain a healthy lifestyle, but talk with your doctor about your specific health concerns, and follow your doctor’s advice.

Preventive Health Guidelines

Benefits for Preventive Services

These preventive services are covered at no cost to you when services are provided by an in-network provider:

  • Services for plans effective on or after 12/1/17
  • Services for plans effective on or after 7/1/17
  • Services for plans effective on or after 1/1/17

Prescriptions and Over-the Counter Medications
Find what prescription medications, over-the-counter medications and supplies are covered at no cost to you when obtained from a network pharmacy.

Grandfathered Plans

If you are on an employer group plan that is grandfathered, your plan may not have implemented the women’s health care and other services under your plan's preventive benefit. Please refer to the below Benefits for Preventive Services and Preventive Health Guidelines to see the services that may apply to your plan.

If you are not sure if your employer group plan has moved to the newest preventive services, contact BCBSNE Member Services at the number on the back of your BCBSNE member ID card.   

Women's Services

Colon Cancer Screening

Colorectal cancer screenings can be a key part of prevention for colon cancer. When is a colonoscopy considered a preventive service versus a medical service? Learn when these services are covered under preventive care.
Colorectal Cancer Screening Overview

HEALTH INSURANCE TERMS


COINSURANCE

The percentage of the bill you pay after your deductible has been met.

COPAY

A fixed amount you pay when you get a covered health service.

Tiered benefit plan

A health care plan featuring multiple levels of benefits based on the network status of a particular provider. 

DEDUCTIBLE

The annual amount you pay for covered health services before your insurance begins to pay.

emergency care services

Any covered services received in a hospital emergency room setting.

SUBSTANCE ABUSE DISORDER SERVICES

Includes behavioral health treatment, counseling, and psychotherapy


in-network provider

A provider contracted by your insurance company to accept an agreed upon payment for covered services. 

OUT-OF-network provider

A term for providers that aren’t contracting with your insurance company. (Your out-of-pocket costs will tend to be more expensive if you go to an out-of-network provider.)

out-of-pocket

Your expenses for medical care that aren’t reimbursed by insurance, including deductibles, coinsurance and co-payments.

penalty

If you can afford health insurance, but choose not to buy it, you must have a health coverage exemption or pay a tax penalty on your federal income tax return.

premium

The amount you pay to your health insurance company each month. 


Preventive services

Health care services that focus on the prevention of disease and health maintenance.

rehab SERVICES

Services and devices to help you recover if you are injured or have surgery. This includes physical, occupational and speech therapy.

special enrollment period

The time after the Open Enrollment Period when you can still purchase health insurance only if you have a qualifying life event (losing other health coverage, having a baby, getting married, moving).

specialist

A physician who has a majority of his or her practice in fields other than internal or general medicine, obstetrics/gynecology, pediatrics or family practice.