Medical Provider Newsletter - June 2019

Preventive care for EMI Health members

EMI Health medical plans cover many preventive services without cost to the member when received by participating providers. Preventive services are those provided when no symptoms or diagnosed medical conditions exist. For services to be covered as preventive, the claims must be submitted with preventive codes. If a preventive service identifies a condition that needs further testing or treatment, regular copayments, coinsurance, or deductibles may apply. 

Here are some common preventive services that are covered with no patient cost:

  • Routine physical exam
  • Routine vision exam*
  • Routine hearing exam
  • Routine gynecological exam
  • Routine Pap smear
  • Screening mammogram
  • Screening colonoscopy
  • FDA-approved contraception
  • Immunizations recommended by the CDC's Advisory Committee on Immunization Practices

The full list of Affordable Care Act (ACA) covered preventive services can be found at https://www.uspreventiveservicestaskforce.org/Page/Name/uspstf-a-and-b-recommendations/

*To be covered at 100 percent, the claim must be submitted to the medical plan. Vision plans will require the stated copay for vision exams.