Use your preventive care benefits

Stay healthy and catch problems early for easier treatment

Our health plans offer all the preventive care services and immunizations below at no cost to you.¹

If you are not sure which exams, tests, or shots are right for you, talk to your doctor.

Preventive care vs. diagnostic care: Knowing the difference

Preventive care helps protect you from getting sick. If your doctor recommends services when you have no symptoms, that's preventive care. Diagnostic care is when you have symptoms, and your doctor recommends services to determine what's causing those symptoms.

Adult preventive care

General preventive physical exams, screenings, and tests (all adults):

• Alcohol and drug misuse: related screening and behavioral counseling
• Anxiety, depression, and suicide risk screenings
• Aortic aneurysm screening (for men who have smoked)
• Behavioral counseling to promote a healthy diet and physical activity
• High blood pressure (hypertension) screening
• Bone density test to screen for osteoporosis
• Cholesterol and lipid (fat) levels screening
• Colorectal cancer screenings, including fecal occult blood test, barium enema, flexible sigmoidoscopy (exam of the large intestine), screening colonoscopy and related prep kit, and computed tomography (CT) colonography (as appropriate)²
• Diabetes screening (type 2)³
• Exercise interventions to prevent falls in adults over age 65
• Hepatitis B virus (HBV) screening for people at increased risk of infection
• Hepatitis C virus (HCV) screening
• Hearing screening
• Height, weight, and body mass index (BMI) measurements
• Human immunodeficiency virus (HIV): screening and counseling
• Interpersonal and domestic violence: screening and counseling
• Lung cancer screening for adults aged 50 to 80 years who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years²
• Obesity: related screening and counseling³
• Prostate cancer screenings, including digital rectal exam and prostate-specific antigen (PSA) test
• Sexually transmitted infections: related screening and counseling
• Syphilis infection screening for persons who are at increased risk
• Tobacco use: related screening and behavioral counseling
• Tuberculosis screening

Women's preventive care:

• Breast cancer screenings, including exam, mammogram, and genetic testing for BRCA1 and BRCA2 when certain criteria are met⁵
• Breastfeeding: primary care intervention to promote breastfeeding support, supplies, and counseling^6,7,8/9
• Chlamydia and gonorrhea screening
• Contraceptive (birth control) counseling
• Counseling related to chemoprevention for those at high risk for breast cancer
• Counseling related to genetic testing for those with a family history of ovarian or breast cancer
• Food and Drug Administration (FDA)-approved contraceptive medical services, including sterilization, provided by a doctor
• Human papillomavirus (HPV) screening⁷
• Pelvic exam and Pap test, including screening for cervical cancer
• Pregnancy screenings, including gestational diabetes, hepatitis B, asymptomatic bacteriuria, Rh incompatibility, HIV, healthy weight, preeclampsia, and depression⁷
• Urinary incontinence screening
• Well-woman visits

Immunizations:

• Diphtheria, tetanus, and pertussis (whooping cough)
• Hepatitis A and hepatitis B
• Human papillomavirus (HPV)
• Influenza (flu)
• Measles, mumps, and rubella (MMR)
• Meningococcal (meningitis)
• Monkeypox and/or smallpox (at risk)
• Pneumococcal (pneumonia)
• Respiratory syncytial virus (RSV)
• Severe acute respiratory syndrome coronavirus 2 (SARS CoV 2)(COVID-19)
• Varicella (chickenpox)
• Zoster (shingles)

Child preventive care

Preventive physical exams, screenings, and tests:

• Anemia screening
• Anxiety, depression, and suicide risk screenings
• Autism Spectrum Disorder (ASD) screening
• Blood pressure screening
• Cervical dysplasia (abnormal cell growth on the cervix) screening
• Cholesterol and lipid (fat) levels screening
• Development and behavior screening
• Diabetes screening (type 2)
• Hearing screening
• Height, weight, and BMI measurements
• Hemoglobin or hematocrit (blood count) screening
• Hepatitis B screening
• HIV screening
• Lead testing
• Newborn screening
• Obesity: related screening and counseling
• Ocular prophylaxis for Gonococcal Ophthalmia Neonatorium: Preventive medication: newborns
• Oral (dental health) assessment, when done as part of a preventive care visit
• Sexually transmitted infections: related screening and counseling
• Skin cancer counseling for those ages 6 months to 24 years with fair skin
• Sudden cardiac arrest/death risk assessment
• Tobacco, alcohol, and drug use assessments
• Vision screening for those ages 6 months to 5 years

Immunizations:

• Chickenpox
• Flu
• Haemophilus influenza type B (HIB)
• Hepatitis A and hepatitis B
• Human papillomavirus (HPV)
• Meningitis
• Measles, mumps, and rubella (MMR)
• Pneumonia
• Polio
• Respiratory syncytial virus (RSV)
• Rotavirus
• Severe acute respiratory syndrome coronavirus 2 (SARS CoV 2)(COVID-19)
• Whooping cough

If you'd like more help understanding your preventive care benefits, call the Member Services number on your health plan ID card.

¹ The range of preventive care services covered at no cost share when provided by plan doctors is designed to meet state and federal requirements. The Department of Health and Human Services decided which services to include for full coverage based on U.S. Preventive Services Task Force A and B recommendations, the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC), and certain guidelines for infants, children, adolescents, and women supported by Health Resources and Services Administration (HRSA) guidelines. You may have additional coverage under your insurance policy. To learn more about what your plan covers, see your certificate of coverage or call the Member Services number on your ID card.

² You may be required to receive preapproval for these services.

³ The Centers for Disease Control and Prevention (CDC)-recognized diabetes prevention programs are available for overweight or obese adults with abnormal blood glucose or who have abnormal CVD risk factors.

⁴ Some plans cover additional vision services. Please see your contract or certificate of coverage for details.

⁵ Check your medical policy for details.

⁶ Breast pumps and supplies must be purchased from suppliers or retailers in your plan's network for 100% coverage. We recommend using plan durable medical equipment (DME) suppliers.

⁷ This benefit also applies to those younger than age 19.

⁸ You may pay a share of cost for other prescription contraceptives, based on your drug benefits. Your cost share may be waived if your doctor decides that using the multisource brand or brand name is medically necessary.

^8/9 Counseling services for breastfeeding (lactation) can be provided or supported by a doctor or facility in your plan's network, such as a pediatrician, OB-GYN, or family medicine doctor, and hospitals with no member cost share (deductible, copay or coinsurance). Contact the provider to see if such services are available.

Anthem Blue Cross and Blue Shield is the trade name of: In Colorado: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. In Connecticut: Anthem Health Plans, Inc. In Indiana: Anthem Insurance Companies, Inc. In Georgia: Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. and Community Care Health Plan of Georgia, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Maine: Anthem Health Plans of Maine, Inc. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc., dba HMO Nevada. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. HMO plans are administered by Anthem Health Plans of New Hampshire, Inc. and underwritten by Matthew Thornton Health Plans, Inc. In 17 southeastern counties of New York: Anthem HealthChoice Assurance, Inc., and Anthem HealthChoice HMO, Inc. In these same counties Anthem Blue Cross and Blue Shield HP is the trade name of Anthem HP LLC. In Ohio: Community Insurance Company. In Virginia: Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield and its affiliate HealthKeepers, Inc. trades as Anthem HealthKeepers providing HMO coverage, and their service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. In Wisconsin: Blue Cross Blue Shield of Wisconsin (BCBSW), underwrites or administers PPO and indemnity policies and underwrites the out-of-network benefits in POS policies offered by Compcare Health Services Insurance Corporation (Compcare) or Wisconsin Collaborative Insurance Corporation (WCIC). Compcare underwrites or administers HMO or POS policies; WCIC underwrites or administers Well-Priority HMO or POS policies. Independent licensees of the Blue Cross and Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.