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    How healthy are you? Find out for free
      

Promote your health by utilizing the city’s benefits plans, which offer wellness exams, screenings, immunizations, information and management resources that cost you little or nothing. Check this chart and find out how you can take charge at no charge.

Free and low-cost wellness benefits

Health Plan

HMO

PPO In-Network

Well-woman exam

$0 copayment for annual clinical breast exams, pelvic exam & pap smear. Mammogram included for women over age 40. Ask for a well-woman exam.

Well-man exam

$0 copayment for annual prostate cancer screening for members age 50 and older. The screening includes prostate examination and prostate specific antigen test. Age may vary for men with cancer risk factors. Ask for a well-man exam.

Well-baby & well-child exam

$0 copayment up to age 17.

$30 copayment

Newborn hearing screening,

diagnosis and treatment

$0 copayment from the child’s birth until the baby is 30 days old. $0 copayment for medically necessary diagnosis and treatment from birth to age 2.

$0 copayment from the child’s birth until the baby is 30 days old. $30 copayment for medically necessary diagnosis and treatment after 30 days.

Routine immunizations

$0 copayment

$0 copayment for children to age 6.

Vision/hearing/speech services

$0 copayment for children through age 17 for routine screenings when performed by the PCP.

$30 copayment

Laboratory & radiology services

$0 copayment when the services are prescribed as the result of a doctor visit.

Diabetic education and self-monitoring training

$0 copayment for diabetics and their families.

$30 copayment

Smoking cessation

The plans pay $185 for one annual course of stop-smoking prescription drugs.

Osteoporosis screening

$0 copayment

$30 copayment

Colorectal cancer screening

If the doctor performs a procedure, like removing polyps, an outpatient copayment is required

$0 copayment for members 50 and older or members with cancer risk factors. Fecal occult blood test every year. Flexible sigmoidoscopy every 5 years. Colonoscopy every 10 years.

$30 copayment. Fecal occult blood test every year. Flexible sigmoidoscopy every 5 years. Colonoscopy every 10 years.

Dental Plan

DHMO

Dental Indemnity

Preventive and diagnositic dental services

$0 copayment for most preventive and diagnostics dental services, including exams, cleaning, scaling, bite-wing X-rays, and sealants for children to age 14. For a complete list of DHMO services that don’t require a copayment, refer to National Pacific Dental’s DHMO Enrollment Kit / Membership Handbook. Note: You will be required to pay a $3 infection control fee each visit.

Supplemental Insurance Plan

Cancer

Provides a $75 wellness benefit per calendar year to each covered employee and/or dependent when charged for one of the following: mammogram, breast ultrasound, pap smear, biopsy, flexible sigmoidoscopy, hemocult stool specimen, chest X-ray and other cancer screenings.

Accident/disability

Provides a $60 annual wellness benefit for any one family member to undergo routine examinations or other preventive tests. After 12 months of coverage, this benefit is paid once each plan year, May - April.

Hospital indemnity

Provides a $50 annual wellness benefit for any one family member receiving routine examinations or other preventive testing following each May 1 anniversary of the policy’s effective date. After 12 months of coverage, this benefit is paid once each plan year, May - April.

Note: Medical plans do not require referrals for the well-woman and well-man exam. HMO members must use a doctor within the PCP’s medical group. Tests and services under the HMO medical plan require referrals from the PCP and that services be given within the PCP’s medical group. Kelsey-Seybold Clinic does not require a referral to specialists within Kelsey-Seybold. PPO members may self-select their health-care providers. A higher benefit is paid when services are received within the PPO network.