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Preventive health services: what you need to know

Even if you're feeling fine, making an appointment with your doctor for preventive care services is important. Through an annual wellness visit and routine health screenings, your doctor can figure out your current health status. They can also catch early warning signs of more serious, costly problems.

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Preventive care plays an important part in keeping you healthy. It also helps find issues before you have symptoms. And just like you, your preventive care needs can change over time. Sign in to view your personal health reminders.

Common preventive services: what's covered
Type of service What's covered What's not covered

Annual wellness visit

This visit is prevention focused, not problem focused

Routine services where your doctor looks at:

  • Past medical, social, and family history
  • Medicines

Age- /gender-appropriate screening tests

  • New health problems talked about with your doctor during your visit
  • Diagnoses such as high blood pressure, diabetes, skin rash, and headaches

Immunizations

Your doctor will suggest immunization that can protect against serious diseases.

Routine wellness visits where your doctor reviews the following:

  • Flu vaccination
  • Hepatitis A & B
  • MMR (measles, mumps, rubella)

Routine services where your doctor looks at:

  • Typhoid
  • Malaria
  • Rabies

Screenings

Your doctor will decide what tests or health screenings are needed based on your age, gender, and overall health status.

  • Breast cancer screening (Mammography) for women over age 40
  • Colorectal cancer screening for adults over age 45
  • Blood pressure screening for all adults
  • Cholestrerol screening for adults of certain age at higher risk
  • More testing and follow-up procedures if abnormal
  • Request for a vitamin D-level check to test for bone and muscle development and function
  • Request for a vaccination filter test to determine acceptable amounts of vaccine antibodies in the bloodstream
Covered preventive health plan benefits

During your visit, your doctor will decide what tests or health screenings are right for you. This is based on your age, gender, health status, and family history. Plus, recommended preventive health services are available at no extra cost when using in-network doctors.*

What's not covered

If you talk about new concerns or a current illness, the visit may be considered a medical treatment visit. At that point, it would not be covered as preventive health services. You will have to pay the plan's doctor office visit copayment or coinsurance.

Preventive care coverage guide

Some services you get at an annual wellness visit may not be considered preventive. This guide shows some common services and whether they’re usually covered at no extra cost.

Understanding your medical costs

After your annual wellness visit you will get an Explanation of Benefits (EOB) from Blue Shield of California to let you know that we processed your claim.

This document gives you information about how your claim was paid, including your payment responsibility or reimbursement, if any.

 

Please note that your doctor will select the medical code for the services provided. They will bill for those services according to their viewpoint.

 

To keep your health on track, take advantage of preventive care benefits.

 

Take control of your health today

Preventive care is key to staying healthy and catching issues early.

Stay healthy with preventive care

Explore preventive health guidelines and work towards your health goals.


Men (Age 20 to 49)

Women (Age 20 to 49)

Children (Age 0 to 2)

Children (Age 3 to 19)

Seniors (Age 50+)

*This is an example of what’s often included. You may incur out of pocket costs during your doctor visit or follow-up visits for services that fall outside of preventive health care. Please confirm your health coverage to verify costs prior to your visit with your doctor if you are unsure of your coverage. Log in to your online account to see what your plan covers.

Blue Shield of California is not a healthcare provider and does not provide medical advice. This is for informational purposes only.  Consult with your physician or other qualified healthcare provider with any questions regarding medical services.
 

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Page last updated: 2/27/2026