The Plan covers preventive care that meets standard guidelines as recommended by the Affordable Care Act (ACA). For example, this includes:
- Pap tests for cervical cancer, PSA tests for prostate cancer, colon and rectal cancer screening and mammograms
- Galleri Cancer Detection Test – up to one test per year per enrolled member and per dependent spouse, 50 years of age and older
- Office visits associated with preventive care tests and screenings
- Physical exams and associated screenings, labs and X-rays
- Preventive care testing provided through a health fair
- Immunizations
- Well-baby and well-child exams – after the first 72 hours
- Pediatric oral and vision services to the extent required by the ACA
The Plan pays 100% for Plans A, B, C and D of the allowed amount with no deductible required. For all other preventive care services, the Plan pays 80% of the allowed amount with no deductible required for Plans A, B, and D; for Plan C, the Plan pays 20%. Preventive care services are subject to the PPO provisions of the Plan.
Click here for a list of ACA recommended preventive services.
Use the Coalition Health Centers in Anchorage and Fairbanks for primary and preventive care services, including wellness visits, physicals, immunizations, radiology, minor procedures and lab tests as well as select generic and pre-packaged medications. All services are covered at 100%. Important Note: Each Coalition member health plan sets its own provisions regarding covered services, copays and deductibles. This information is specific to eligible members of the ASEA/AFSCME Local 52 Health Benefits Trust.
