June 2, 2022
Premera has updated its preventive care benefits. These changes are in response to new federal recommendations from the U.S. Preventive Services Task Force (USPSTF) and are effective as of May 31, 2022, for all members with non-grandfathered health plans.
The following is a summary of additional benefits that may now be covered for Premera health plan members by category.
Colorectal cancer screenings
Follow-up colonoscopy following a positive home test.
Pregnancy, reproductive, and other women’s health
- Contraception – All FDA-approved, cleared, or granted contraceptive products prescribed by a provider, with no fail-first or ABD process requirements
- Healthy weight in pregnancy - Effective behavioral counseling interventions aimed at promoting healthy weight gain and preventing excess gestational weight gain in pregnancy
- Gestational diabetes - Screenings for gestational diabetes in asymptomatic pregnant persons at 24 weeks of gestation or after
- Preeclampsia - Low-dose aspirin (81 mg/day; requires written prescription) as preventive medication after 12 weeks of gestation in persons who are at high risk for preeclampsia
- Chlamydia and gonorrhea - Screening for chlamydia and gonorrhea in all sexually active women 24 years or younger and in women 25 years or older who are at increased risk for infection
Diabetes
The age for prediabetes and diabetes screening will be lowered from age 40 to age 35 for asymptomatic adults with overweight or obesity for prediabetes and diabetes.
Pediatric dental
- Fluoride varnish – Fluoride varnish to the primary teeth of all infants and children starting at the age of primary tooth eruption
- Oral fluoride - Oral fluoride supplementation starting at age 6 months for children whose water supply is deficient in fluoride
Visit our medical policy and coding updates page for more information about preventive coverage and benefits. Resources will be updated on/after effective dates, as applicable.