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Preventive Care - Covered at 100%

Keeping You Healthy So You Can Serve

Keeping you healthy is a priority for Concordia Plan Services – and a focus on preventive care can help you stay healthy. Routine screenings, check-ups and vaccines and lab work can make sure that you can not only manage your health and help you avoid serious health problems.

Best of all, eligible preventive care may be covered at 100%. Eligible care includes care by an in-network physician for preventive purposes (they need to be medically coded and billed as preventive – here is a Provider Care Notice that can help with that). Diagnostic (medical claim) services aren’t covered. Some examples of eligible care include:

  • 2D and 3D mammograms are preventive due to age or family history (diagnostic due to pain or detection of a lump).
  • Colon cancer screenings. Preventive due to age (including polyp removal, but not polyp testing). General anesthesia is not covered unless deemed medically necessary, but local anesthesia is covered as preventive.
  • Skin exams. Routine exams are preventive, but sores and other medical care for symptoms is diagnostic.
  • Blood testing. Routine monitoring screenings are preventive, but tests ordered and completed for symptoms are diagnostic.
  • Lab tests performed in the doctor’s office. Off site-testing can be billed as diagnostic.

Questions? Contact Concordia Plan Services at 888-927-7526 or UMR at 1-877-233-1800.

Preventive Care Guide