Open Enrollment

Preventive care is medical care provided not for a specific complaint, but
focused on prevention and early detection of disease or illness. You should have these services at least as often as outlined in the guidelines developed by the Preventive Care Task Force. The State of Ohio benefits provide these services - or allows for more frequent treatment — than recommended. Some services do not have any frequency limitations. Refer to the Health Care and Long Term Care Employee Benefits handbook or call your plan for more
information.

The health plans provide the following services at 100 percent. Some services may require a $15 copay.

  Immunizations
    • Children’s recommended immunizations through age 16
    • Tetanus immunizations as recommended
    • Influenza immunizations for adults annually beginning at age 18
    • Pneumonia
    • Meningitis
    • Rubella

  Routine Tests
    • Routine physical examinations
    • Blood pressure
    • Cholesterol
    • Clinic breast exam
    • Pap Test
    • Mammograms (beginning at age 40)
    • Fecal occult blood test (beginning at age 50)

  Exams and Screenings
    • Protein specific antigen (PSA) tests
    • Cervical cancer screening
    • Colonoscopy and sigmoidoscopy

Treatment and Care
• Prenatal obstetrical care


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14 PREVENTIVE HEALTH CARE SERVICES New for June 2006 to July 2007: • *Preventive care benefits paid at 100 percent. Some services may require a $15 copay.*	Preventive care is medical care provided not for a specific complaint, but focused on prevention and early detection of disease or illness. You should have these services at least as often as outlined in the guidelines developed by the Preventive Care Task Force. The State of Ohio benefits provide these services - or allows for more frequent treatment — than recommended. Some services do not have any frequency limitations. Refer to the Health Care and Long Term Care Employee Benefits handbook or call your plan for more information. The health plans provide the following services at 100 percent. Some services may require a $15 copay. Immunizations • Children’s recommended immunizations through age 16 • Tetanus immunizations as recommended • Influenza immunizations for adults annually beginning at age 18 • Pneumonia • Meningitis • Rubella Routine Tests • Routine physical examinations • Blood pressure • Cholesterol • Clinic breast exam • Pap Test • Mammograms (beginning at age 40) • Fecal occult blood test (beginning at age 50) Exams and Screenings • Protein specific antigen (PSA) tests • Cervical cancer screening • Colonoscopy and sigmoidoscopy Treatment and Care • Prenatal obstetrical care

		Health Management Programs (formerly disease management) If you have a disease, such as diabetes or asthma or another disease that is covered by your plan’s health management program, a nurse or other medical professional will work with you to help manage your condition. The medical professional will formulate a personal plan for you through this free, voluntary program. All the plans offer health management programs for diabetes, asthma and at least one additional condition. They also pay for the programs in full with no deductibles or copayments. For patients with chronic diseases, the anticipated benefits of these programs include superior clinical outcomes, improved quality of life, lower health care costs, less need for hospital visits or surgery and greater access to care. For more information about the health management programs offered by each plan, see the comparison chart. If you have a disease listed for your plan and have not been contacted, contact the plan for information.