Preventive Care and Health Maintenance: Live healthy.
Nothing is more important than your health. And nothing is more important to protecting your health than receiving regular preventive care. That's why your MCHA health plan provides coverage for preventive visits. We want you to visit your doctor regularly for important screenings and immunizations that ensure you stay as healthy as possible. To learn more about recommended screenings for you and your family, use our helpful guides to preventive services and immunization schedules below.
MCHA is committed to keeping its members informed about how to live healthy. Please let us know how you prefer to receive information from us about living healthy by completing a short survey.
What is covered under your preventive benefit?
Health care services are covered as "preventive care" by MCHA when the patient has no complaint about his/her health and there is no existing medical condition being treated at the time of the preventive care appointment. In deciding what to cover under your preventive benefit, MCHA consults guidelines developed by such independent medical organizations as the Institute for Clinical Systems Improvement, the American Cancer Society, the Centers for Disease Control, and United States Preventive Services Task Force.
Please note: In-network providers are paid using various types of contractual arrangements, which are intended to promote the delivery of health care in a cost efficient manner. For in-network and out-of-network benefits, see your MCHA Policy of Coverage. Call MCHA Customer Service at the number listed on the back of your ID card or visit Find a Doctor on Medica.com for help in identifying an in-network physician.
Sometimes members have questions about what their health plan covers as “preventive care.” View the chart below to learn more about the services MCHA typically covers under the preventive benefit. For more information, please refer to your MCHA Policy of Coverage or contact MCHA Customer Service at the phone number listed on the back of your ID card.
| Preventive Service Recommended | Frequency Covered by Benefit Plan |
Medical Exam, including
- Counseling on healthy lifestyle
- Testicular exam
- Prostate digital rectal exam
- Breast exam
- High blood pressure screening
- BMI
| As recommended by physician |
Vision Screening
- Eye exam, including glaucoma screening
| As recommended by physician |
| Hearing Screening | As recommended by physician |
| Immunizations | As recommended by Centers for Disease Control. View recommendations for Childhood Immunizations View recommendations for Adult Immunizations |
| Osteoporosis Screening (Bone Density Test) | 1 per year or as recommended by physician |
Laboratory Services, including
- Cholesterol/lipid profile (for those without a diagnosis of high cholesterol)
- Thyroid screening
- Diabetes screening
- Hemoglobin
- Urinalysis
| As recommended by physician |
| Sexually Transmitted Disease Screening | As recommended by physician |
Colon Cancer Screening
- Stool test
- Barium enema
- Sigmoidoscopy
- Colonoscopy
| As recommended by physician |
| Cervical Cancer Screening (Pap Smear) | 1 per year or as recommended by physician |
| Breast Cancer Screening (Mammogram) | 1 per year or as recommended by physician |
| Prostate Cancer Screening (PSA -- Prostate Specific Antigen) | 1 per year or as recommended by physician |
Following your appointment, your physician submits a claim with codes representing the services he or she provided to you. If significant time is spent discussing a health issue, your physician may code part of the visit as “non-preventive.” This varies by physician.
Preventive Care Fact Sheets
Frequently Asked Questions