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Well-Baby, Well-Child Care

Preventive Health Care for Infants and Children (0 Months-18 Years)
Well-baby, well-child care provides coverage for recommended immunizations and the office visit at the time of the immunization. The immunization schedule is based on the recommendations of the American Academy of Pediatrics, the American Academy of Family Practice Physicians and the U.S. Task Force for Preventive Services. The plan also covers a Phenylketonuria (PKU) lab test performed at birth and a well-baby office visit with a PKU lab test two to three weeks following birth.

Cigna Copay Plan and regional HMOs
Preventive health services are also covered 100 percent under the CIGNA Copay Plan and the regional HMOs offered by TI. The list of covered services may vary slightly, so contact your insurance carrier's customer service department for details, using the contact numbers on your insurance ID card.

Under the Blue Cross Blue Shield PPO and High-Deductible Health Plan (HDHP), expenses for recommended immunizations and lab tests are covered at 100 percent. No copay, coinsurance or deductibles apply.

If you use a provider from outside the BCBS network, services will be covered at 100 percent of the allowable amount..

The following immunization schedule is a guide and represents the maximum number and type of immunizations and lab tests that are covered by the Blue Cross Blue Shield HDHP and PPO. Your physician may prescribe an actual interval for immunizations and PKU lab tests consisting of approximately eight well-baby checkups for the baby's first year.

Reminder: To add coverage for a newborn child or newly adopted child (adopted or placement for adoption), coverage must be elected within 60 days from the date of birth, date of adoption or date adoption papers were filed.

Well-Baby, Well-Child Care, 2017
Immunizations and lab tests covered by the Blue Cross Blue Shield HDHP and PPO
Immunizations* Ages Covered Recommended Frequency
Diphtheria/Tetanus/Pertussis (DTP)** 0 to 18 One series
Flu vaccine (inactivated and live-attenuated) 0 to 18 Annually
Human Papillomavirus (HPV) vaccine (Gardasil® , for example) 9 to 18 One series
H. influenza type B (Hib) ** 0 to 18 One series
Hepatitis A 0 to 18 One series
Hepatitis B 0 to 18 One series
Measles/Mumps/Rubella (MMR) 0 to 18 One series
Meningococcal (conjugate and polysaccharide) 0 to 18 One series
Pneumococcal (conjugate and polysaccharide) 0 to 18 One series
Polio (inactived) 0 to 18 One series
Prevnar 0 to 18 One series
Rotavirus 0 to 18 One series
Tuberculosis Test (TB) 0 to 18 Once only
Varicella Zoster (Chicken Pox) 0 to 18 One series for those not previously immunized
Office Visit Ages Covered Recommended Frequency
Physical Development Assessment 0 to 18 Annually
Screening for Autism At 18 and 24 months     At 18 and 24 months
Alcohol and Drug Use Assessments Adolescents Annually
Developmental Screening 0 to 18 Annually
Behavioral Assessments 0 to 18 Annually
Blood Pressure Screening 0 to 18 Annually
Fluoride treatment (for children whose primary water source is deficient in fluoride) 6 months to 6 years Annually
Hearing Loss Screening Newborns Once only
Height, Weight And Body Mass Index 0 to 18 Annually
Iron supplements for those at risk for anemia 6 to 12 months As needed
Gonorrhea Prevention Medication for the eyes Newborns Once only
Oral Health Risk Assessment 0 to 10 years Annually
Screening for Depression 12 to 18 Annually
Screening for Hepatitis B 12 to 18 for those with high risk of infection Periodically
Screening for Obesity 6 and older Annually
Tobacco prevention counseling 0 to 18 As needed
Vision Acuity Screening By age 5 years Once only
Lab Tests Ages Covered Recommended Frequency
Cholesterol 0 to 18 Once only
Papanicolaou (Pap) Test (including ThinPrep(TM) and HPV testing) Those sexually active Every 3 to 5 years for females
HIV Screening Those sexually active At least annually
Testing for Chlamydia, Gonorrhea and Syphilis Those sexually active Annually
Hematocrit 0 to 18 Annually
Hemoglobin 0 to 18 Annually
Urinalysis 0 to 18 Annually
Lead Screening 0 to 6 Once only
Test for Iron Deficiency Anemia for children at increased risk 6 to 12 months Once only
Phenylketonuria (PKU) Newborns to age 1 At birth and 2-3 weeks after birth
Dyslipidemia Screening 0 to 18 Annually
Hypothyroidism Screening Newborns Once
Sickle Cell Disease Newborns Once
* Immunizations can also be obtained at no cost through CVS Caremark's in-network pharmacies (subject to availability). Certain immunizations, through any pharmacy, may require a physician's prescription.
** If your doctor chooses, Tetramune can be given instead of DTP and Hib.

Reminder: To add coverage for a newborn child or newly adopted child (adopted or placement for adoption), coverage must be elected within 60 calendar days from the date of birth, date of adoption or date adoption papers were filed.

Well-Baby, Well-Child Checkups: One physical development assessment office visit per calendar year will be covered.


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  Web page revisions made March 2017.
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