FYI: Take a Look at the Preventive Services Covered by Wellmark

If you’ve ever wondered about the preventive services Wellmark provides coverage for… 

In accordance with the Affordable Care Act (ACA), Wellmark provides coverage for preventive services when they are delivered by in-network providers. Benefit coverage and cost sharing will still apply for out-of-network services as specified by member coverage manuals. Additionally, health plans may apply cost sharing to out-of-network preventive care and use reasonable medical management techniques to help control costs and promote efficient delivery of care. 

Preventive services are defined under Section 2713 of the ACA as immunizations, screenings and other services that are listed as recommended by the United States Preventive Services Task Force (USPSTF), the Health Resources Services Administration (HRSA) or the federal Centers for Disease Control (CDC). The services identified by the ACA to clinicians are recommendations, not mandated services. Clinicians are best able to determine which services to provide. 

Examples of Services Covered 

• Annual wellness examination 
• Colorectal cancer screening 
• Depression screening 
• HIV screening: for all adults through age 65 and older adults who are at increased risk 
• Immunizations: Hepatitis A; Hepatitis B; Herpes Zoster; Human Papillomavirus (HPV); Influenza (Flu Shot); Measles, Mumps, Rubella; Meningococcal; Pneumococcal; Tetanus, Diphtheria, Pertussis; Varicella 
• Screening mammography (2D): breast cancer screening annually for women age 35 and older 
• Lead screening for children at risk to exposure, birth through 6 years 

The entire list of covered services is now archived on the Intranet > Benefits > Wellmark > Preventive Services Covered List. 

If you have any questions, contact Juliette Houseman, Benefits Specialist.