At Hess, we want you to get checkups now to avoid issues later. That’s why we offer several free preventive care benefits.
PREVENTIVE CARE
But I’m Not Sick
Exactly. And we want to keep it that way. So, make time to see your health care providers and get the right preventive care at every stage of life. It will help you and your family stay healthy and prevent potential health issues from becoming worse (and more expensive) down the road.
Medical Plan
Covered at 100 percent without having to meet the deductible (in-network):
- Well child visits
- Immunizations
- Annual adult physicals (once every 12 months)
- Age-appropriate screenings (such as mammograms and colonoscopies)
- Generic preventive retail and mail order prescription drugs
- See a complete list of services paid at 100 percent
- What the plan pays for care
- List of covered preventive services recommended by the Affordable Care Act
- What to expect at your preventive care visit
- Questions to ask your provider
- List of preventive drugs
- Prescription drug overview
- Recommendations for the Early Detection of Breast Cancer (American Cancer Society)
- Colorectal Cancer Screening Guideline (American Cancer Society)
- Recommended Cancer Screening Tests (American Cancer Society)
- Cancer Screening Guidelines by Age (American Cancer Society)
Vision
Covered at 100 percent, no deductible (in-network):
- Annual eye exam (once every 12 months)
Dental
Covered at 100 percent, no deductible (in-network or out-of-network) and does not count toward the $2,000 annual maximum plan benefit:
- Two checkups within a 12-month period (must be six months apart)
Additional preventive care benefits are available for those with chronic medical conditions — such as diabetes or heart disease — through SmileWay Wellness Benefits.
Preventive Care Versus Diagnostic Care: What’s the Difference?
As explained in the Anthem Preventive Care Flyer, “Preventive care helps protect you from getting sick. If your doctor recommends you have services even though 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.” So, keep in mind, if your doctor wants to investigate a health issue as a result of your annual physical, you may have to pay out of pocket for those diagnostic services.
Need to Find a Doctor or Dentist?
If you don’t have a primary care provider, you should get one. Having a doctor who knows your health history and can help coordinate your care is very important. It’s also important to use in-network doctors, so you get the care you need at the lowest cost.
- Medical and Vision Providers: Use the Anthem Find Care tool. Find instructions and the Anthem website link on the Tools page. Scroll down to the Find Care tool tile.
- Dental Providers: Use the Find a Dentist tool. Find instructions and the Delta Dental website link on the Tools page. Scroll down to the Find a Dentist tile.
KNOW THE CODE
Be sure to check that your provider codes your preventive services properly or services will be considered diagnostic, resulting in out-of-pocket charges.