Preventive Services Updates Coming May 31, 2022

  • May 17, 2022

    Learn about upcoming changes to our preventive care benefits.

    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 May 31, 2022, for all members with non-grandfathered health plans.

    2022 Updates

    The following is a summary of additional benefits that may now be covered for your employees by category.

    Colorectal cancer screenings

    Follow-up colonoscopy following a positive home test (frequency limits and cost shares may apply).

    Pregnancy, reproductive, and other women’s health

    • Contraception - All FDA-approved, cleared, or granted contraceptive products that are prescribed by a provider, with no fail-first or Adverse Benefit Determination (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 who are overweight or obese.

    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

    Tips to help your employees

    Preventive care benefits can help your employees stay healthy. Encourage them to use their benefits by:

    • Reminding your employees that preventive benefits are paid in full when in-network providers are used.
    • Sharing the updated preventive services list. (Updates will be listed on or /after the May 31 effective date.)
    • Using the ready-to-share resources about preventive services in B’link.
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