Preventive care list FAQs

Preventive care list FAQs

 Am I eligible for these preventive services?

Most people enrolled on an active Asuris policy have 100% coverage for preventive services. You may not be eligible if you’re on a grandfathered policy or retiree-only plan. (Upon your group’s renewal beginning Jan. 1, 2019, state law requires preventive care coverage on certain grandfathered plans.) Call Customer Service at the phone number on the back of your member ID card or sign in and use the Live Chat feature on asuris.com to learn more about your preventive care benefits.

 How does Asuris decide which preventive services to cover?

We support federal and state government mandates to cover a wide range of preventive services at 100%. Our benefits follow recommendations from three government agencies and state law to determine which services we cover. These scientifically supported guidelines are created by the United States Preventive Services Task Force (USPSTF), Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention (CDC), and Health Resources and Services Administration (HRSA).

These recommendations change regularly to reflect scientific and medical advances and research. When the federal recommendations change, we adopt them within one year of their publication. Visit healthcare.gov for more information, including recommended child and adolescent immunization schedules.

 How much will I pay?

You pay nothing for the services listed (you won’t owe any deductible, coinsurance or copay) when you see preferred (Category 1), participating (Category 2) or in-network providers. You may have to pay the deductible and/or coinsurance if you see non-participating (Category 3) or out-of-network providers. Also, if your doctor provides preventive services that are outside the government guidelines, you may have an out-of-pocket expense.

 What should I know before I make a preventive care appointment?

It’s always a good idea to call the number on the back of your member ID card before going to the doctor because:

We may add new benefits or change existing ones as a result of updated recommendations.

Your benefits may have limits (such as age ranges or the number of services per year).

Some services require pre-authorization and must meet guidelines for medical necessity.

 What about travel vaccines?

If you have international travel plans, make sure you’re up to date on your routine preventive vaccines. Check with the Centers for Disease Control and Prevention (CDC) for any additional recommended vaccines related to your specific travel destination. Please contact Customer Service for information on your travel vaccines benefit.