Even if you’re healthy and feeling good, it’s important to keep up with your preventive care. Periodic health exams, cancer screenings, vaccines and other recommended preventive care services help prevent or detect problems early on when they’re easier to treat. The good news is that, generally, Regence health plans cover preventive care in full when you see an in-network provider. Some plans may have limitations or may not cover all of these services. Sign in to review your benefits or to find care in your network.
We follow recommendations from three government agencies to determine which services we cover.* When you see an in-network provider, you’ll pay nothing for the preventive services listed here. To easily find providers in your network, sign in and find a doctor.
You may be responsible for an out-of-pocket expense if:
- You see an out-of-network provider
- Your doctor provides preventive care outside the guidelines
- Your provider doesn’t obtain any required pre-authorization
*These scientifically supported guidelines are created by the United States Preventive Services Task Force (USPSTF), Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention (CDC), and Health Resources and Services Administration (HRSA).
Preventive care is precautionary and routine, like an annual physical. Diagnostic care diagnoses or treats new symptoms or existing problems, like additional treatment you receive after a screening detects something abnormal. Let’s say your in-network doctor wants you to get a colonoscopy to screen for colorectal cancer because of your age. This is considered preventive care. However, if your doctor wants you to get a colonoscopy because of symptoms you’re having, then it’s considered diagnostic care.
Why does this distinction matter? Because while in-network, recommended preventive care is covered in full without any out-of-pocket expense to you, diagnostic care may come with costs like copays or deductibles. So, if your doctor recommends a specific test or procedure, be sure to ask if it’s for preventive or diagnostic purposes—that way you’ll know what type of coverage to expect.
Check the list below to see which preventive services most of our plans cover. Some plans may have limitations or may not cover all of these services. If you have any questions, check your benefits or call Customer Service at the number on the back of your member ID card.