Healthier You

Health insurance is the first step to becoming your healthiest self, but prevention is just as important.

We’ve got tips to make the most of your benefits; especially those covered 100 percent with no co-pay, to stay on top of your health. These tips are a great start to understanding your coverage. 

Wellness Tips

1. Wellness Exams.

A yearly checkup with your primary care provider or family doctor is vital to your long-term wellness. Every member is allowed one wellness exam every 12 months at no cost when seeing an in-network provider.

A typical checkup may include:

  • Blood pressure testing
  • Cholesterol check every five years; glucose panel every three years
  • Height and weight check and BMI
  • Individual review of results with a health care professional
  • Urinalysis for women
  • Hemoglobin check for women

Helpful Tips

Your provider must use specific office codes to ensure your yearly checkup is covered at no cost to you. Bring these codes to your checkup to make sure it is covered 100%.

Codes to bring to your providers.

When It's Not Covered

  1. Going to a provider that is out-of-network. By seeing an out-of-network provider, you will pay the full billed amount and the cost will go toward your out-of-network balances. Log in to your member portal to search for providers in your network.
  2. When you ask your provider to solve an ongoing health problem. By referring to a pain or sickness, the visit becomes diagnostic and might not be covered 100% as a "preventive annual wellness visit." This includes "Oh, by the way, could you help me with..." questions about your health that could lead to more testing or drugs.

    You are your best advocate. Your provider decides how to code visits, so don't be afraid to ask if discussing a certain issue will affect how you will be billed for the visit.

2. Covered Preventive Services and Immunizations.

Don't let a minor health problem become a major health problem. Take advantage of your free preventive wellness checkups and other preventive services and immunizations.

To receive health services at the lowest cost to you, always choose a doctor who is an in-network provider. Log in to your member portal to search your provider directory.

3. Talk to Your Physician.

To receive the best possible care, be prepared for your appointment and don't be afraid to ask questions before, during and after your visit.

Take an active role in your health care; after all, it is your body. In order to make informed health care decisions, it's important you understand your options.

4. Staying healthy is the best way to control your health care costs.

  1. Take care of yourself.
  2. Exercise regularly.
  3. Eat a balanced diet.
  4. Get plenty of sleep.
  5. Learn how to effectively deal with stress.
  6. Avoid excessive use of alcohol.
  7. Refrain from all tobacco products.

5. Stay positive.

A negative attitude can only bring you down. Notice how often you have negative thoughts or say something negative - this is a start. Behavioral health benefits are provided in most plans and in all new plans through the Affordable Care Act.

Online Health Guide

The online health guide is available for all Avera Health Plans’ fully insured and Avera MyPlan members. Members have access through a secured portal to store health information and track opportunities to live healthier lifestyles.

Members: Start today by logging in!

Avera Balance

Avera health care professionals and staff come together and share their expert advice, opinions and insights on the Avera Balance. It's a great place to find tips and expertise!