Ensuring that you and your loved ones have health insurance is an important step to becoming healthier, but prevention is just as important.
Take advantage of the wide variety of health and wellness resources offered to Avera Health Plans members (not including Medicare Supplement Insurance members). You'll make the most of your benefits - especially those covered 100 percent with no co-pay - and find the services and support you need to live a healthier life.
Free Wellness Exams & Preventive Services for Members
An annual checkup with your primary care provider or family doctor is vital to long-term wellness. And did you know that annual wellness exams and immunizations may be covered 100 percent - at no charge to you when you see an in-network provider - with most of our health plans?
Learn more about which specific preventive services are covered:
To make sure that your annual checkup is covered 100 percent, your provider must use these preventive medicine visit codes [PDF]. In addition, some of our new plans include two additional free visits with your primary care physician each year.
Log in to the member portal and view your Summary of Benefits and Coverage to find out which specific services are covered by your plan.
When It's Not Covered
Note that annual wellness exams and preventive services will not be covered in the following circumstances:
- When you go to a provider who is out-of-network. If you choose to see an out-of-network provider, you'll pay the full billed amount and the cost will go toward your out-of-network balances. To receive health services at the lowest cost to you, always choose an in-network provider. Log in to the member portal to search for providers in your network.
- 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 percent 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 medications.
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.