For all preventive services that are covered at no cost under Original Medicare, we also cover the service at no cost to you. However, if you also are treated or monitored for an existing medical condition during the visit when you receive the preventive service, a copayment will apply for the care received for the existing medical condition.
Sometimes, Medicare adds coverage under Original Medicare for new services during the year. If Medicare adds coverage for any service during <2017/2018>, either Medicare or our plan will cover those services.
All Preventive benefits covered under Original Medicare at zero cost-sharing have a $0 in-network copayment. If you choose to seek these benefits out-of-network, then there is a yearly plan deductible and a 40% coinsurance for the cost of covered services.
For a detailed explanation of what is included in each preventive service, review Chapter 4 of the Evidence of Coverage.
Abdominal aortic aneurysm screening
Annual wellness visit
Bone mass measurement
Breast cancer screening (mammograms)
Cardiovascular disease risk reduction visit (therapy for cardiovascular disease)
Cardiovascular disease testing
Cervical and vaginal cancer screening
Colorectal cancer screening
Diabetes self-management training, diabetic services and supplies
Medical nutrition therapy
Medicare Diabetes Prevention Program (MDPP)
Obesity screening and therapy to promote sustained weight loss
Prostate cancer screening exams
Screening and counseling to reduce alcohol misuse
Screening for lung cancer with low dose computed tomography (LDCT)
Screening for sexually transmitted infections (STIs) and counseling to prevent STIs
Smoking and tobacco use cessation (counseling to stop smoking or tobacco use)
“Welcome to Medicare” Preventive Visit
Piedmont Medicare Advantage is a PPO plan with a Medicare contract. Enrollment in Piedmont Medicare Advantage depends on contract approval. Out-of-network/non-contracted providers are under no obligation to treat Piedmont Medicare Advantage members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or copayments/coinsurance may change on January 1 of each year.
H1659_Web2018 Approved 10112017