You may help prevent or control illness by
making wise health and lifestyle choices. BCHP supports and covers
preventative health care services. Immunizations help prevent illness and
epidemic in our community. Routine screenings and physical exams help to
discover illness early when it is easier to treat.
"An ounce of prevention is a pound of
cure."
|
Summary
of Wellness Benefits |
| Well-baby
care |
Routine
tests and examinations given to children up to age two |
| Routine
tests and examinations |
Routine
annual physical exam after age two $150 maximum paid per
year. |
|
The routine services listed
below follow current medical standards and the American
Cancer Society Guidelines, are paid in addition to the $150
maximum for an annual physical exam.
|
| Immunization
for infants and children |
Yes |
| Immunization
for adults |
Yes,
including flu vaccine. |
| Pap
smears |
Annually
starting at age 18 for women or earlier if the doctor
recommends. |
| Mammograms |
Annually
after age 40 for women |
| Colon-Rectal
exams |
Annually
starting at age 50 for men and women a fecal occult blood
test plus one of the three screening options below:
• Flexible sigmoidoscopy every 5 years*,
• Colonoscopy every 10 years*, or
• Double contrast barium enema every 5-10 years*.
*Digital rectal examination should be
performed at the time of each screening. |
| Prostate
screening |
Annually
starting at age 50 for men a prostate-specific antigen (PSA)
blood test and the digital rectal examination. |
| Smoking/tobacco
cessation treatment |
Benefits
will be paid at 50% of usual and customary costs, up to a
lifetime maximum of $300 for all Participants.Receipts for
services must be sent to Principal Financial Group for
reimbursement. |
|
"A disease known is half cured"
How do I know what
the current recommended guidelines are for routine screening and
immunizations?
Our plan keeps with the current national medical standards and the American
Cancer Society guidelines.
You may review the latest routine cancer
screening guidelines and self breast and testicular exams from the American
Cancer Society web site. www.cancer.org
You may print the latest Immunization and Vaccine Recommendations for
Infants, Children, and Adults from the Center for Disease Control www.cdc.gov/nip/.
What is the difference between a routine screening
mammogram or a diagnostic mammogram?
A mammogram is an x-ray of the breast. Screening mammography is used to look
for breast disease in women who are asymptomatic, that is, they appear to
have no symptoms.
Diagnostic mammography is used to diagnose breast disease in women who have
symptoms such as development of a lump or swelling in the breast or underarm
area, skin irritation or dimpling, nipple pain or retraction (turning
inward), redness or scaliness of the nipple or breast skin, or a discharge
other than breast milk.
Following the American Cancer Society's guidelines for the early detection
of breast cancer improves the chances that breast cancer can be diagnosed at
an early stage and treated successfully.
Women aged 20 or older should perform breast self-examination (BSE) every
month. By doing the exam regularly, you get to know how your breasts feel
and you can more readily detect any change. If a change occurs, see your
health care provider as soon as possible for evaluation. However, remember
that most of the time, these breast changes are not cancer. Annual routine
mammograms are recommended after age 40 along with the BSE every month.
Is the ThinPrep pap test covered?
Yes. This test is covered.
"Recent studies indicate that this new method can slightly improve
detection of cancers, significantly improve detection of early precancers
and reduce the number of tests that need to be repeated. Whether or not this
method has a significant impact on preventing cancer and whether it is the
best approach to improving the Pap test needs to be studied further. This
method is not used by most laboratories and is more expensive than a usual
Pap test." --Reprinted from the American Cancer Society Web Site 7/00
My spouse, who is in the BCHP plan, had to pay 100%
for the health screening and flu shot held at our school district. I
only paid 20%. Why?
Every year, the wellness coordinators and school districts offer health
screenings and flu shots to employees to promote preventive health care.
Family members who are not employed by the schools are welcome to
participate in employee health screenings, but they must be prepared to pay
the full price and submit a claim for reimbursement to their insurance.
If a BCHP covered spouse also has insurance from their employer, they must
submit to their employer's insurance first and then to Allied, second, for reimbursement consideration. If the employee is a recent
new hire, they may not be in the Allied computer at the
time of the screening. They will also be required to pay up front and submit
their claim for reimbursement.
What tests are included in the employee health
screening?
The provider recommends the health screening tests for apparently healthy
adults without symptoms. These are based on the current guidelines from the
U.S. Preventive Health Service Task Force and national norms. A health risk
appraisal questionnaire is given to participants to complete. The
participant receives a personalized Health Risk Report based on the
individual's health status, health history and lifestyle with national
norms. The report gives the individual the information he/she needs to
freely choose his or her own lifestyle improvement goals.
Remember, the employee health screening will include tests that may be
completed at the work site such as resting heart rate, blood pressure, blood
cholesterol, and blood sugar. Digital rectal exams or pap smears would not
be included in an employee health screening.
A work place health screening is a positive benefit but gives you a
"general" read on your health. This screening should not replace a
routine physical with your physician.
I tried to get a prescription drug, Zyban, for
smoking cessation, but the pharmacy denied my card.
All smoking cessation treatments must be paid up front to the provider
by you and then the receipt may be submitted to Allied
for reimbursement. The benefit is paid at 50% of U/C costs up to a lifetime
maximum of $300. Treatment covered includes hypnosis and smoking cessation
sessions conducted by the American Lung Association, American Cancer
Society, a hospital, physician or certified group leader. Treatment not
covered includes: tapes, books, nicotine gum, videos and mail order
programs.
Remember the
Caremark
drug card will not work for prescription smoking
cessation drugs. Receipts for prescription smoking cessation drugs, nicotine
patch, or completion of a class should be attached to a Principal Financial
Group claim form and submitted to Allied. Contact Allied at 1-800-288-2078 if you have questions about the
benefit.
Check out quitting tobacco tips web sites.
www.lungusa.org
www.nicotine-anonymous.org
