Understanding your preventive care benefits

Even if you're feeling fine, scheduling an appointment with your doctor for preventive care services is important. Through a preventive exam and routine health screenings, your doctor can determine your current health status and detect early warning signs of more serious, costly problems.

What's covered in a preventive care visit

During your visit, your doctor will determine what tests or health screenings are right for you based on factors such as your age, gender, health status, and health and family history. Plus, your medical plan covers 100% of the costs for preventive health services when care is provided through network providers.

What's not considered a preventive care visit

If you discuss new medical concerns or a current illness, the entire visit may be considered a medical treatment visit and would not be covered as preventive care. You will be required to pay the plan's physician office copayment or coinsurance.

Covered or not

Scroll down to see some common services that may or may not be covered during a preventive care visit.

What's covered

Type of service

What's not

Understanding non-preventive costs

After your annual preventive exam, you will receive an Explanation of Benefits (EOB) from Blue Shield of California to notify you that your claim has been processed.

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

It's important to note that your provider has the right to code and bill services according to his or her viewpoint.