Wellmark has informed us of the following policy change effective January 1, 2010.
Our health plan covers a yearly routine physical examination as a preventive benefit. It does not routinely cover “periodic physicals or health examinations, screening procedures, or immunizations performed solely for school, sports, employment, insurance, licensing, or travel.” However, in the past these types of physicals may have been allowed under preventive benefits if this was the member’s only routine physical in a calendar year.
As of January 1, 2010, providers must perform a complete routine physical exam for the service to be covered. This administrative change is meant to encourage members to use their preventive benefits for a full well-child visit. In addition to performing a physical exam for a school or sports physical, the provider will be able to discuss other health concerns. Sports and school physicals will not be covered under your Wellmark BC/BS policy. Any questions may be sent to Kathy Martin, Benefits Specialist, at kmartin@aea11.k12.ia.us.
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