Orchard - Unchanged

Preventive Services

Man getting flu shot

Be proactive about your health with preventive care services

When it comes to disease prevention, getting health screenings and immunizations is important. You can get annual preventive care services at No Cost when you visit an in-network provider - no copay, coinsurance, or deductible. PEHP covers 100% of the cost for preventive care services based on specific eligibility criteria.

Examples of preventive care services:*

  • Immunizations
  • Annual physical exam
  • Breast cancer screening (typically age 40+)
  • Cervical cancer screening (age 21-65)
  • Cholesterol, blood glucose, blood pressure screenings
  • Colonoscopy (cash back available)

What's not considered preventive care?

Treatment for existing health conditions, diagnostic tests for medical conditions, elective surgeries, certain immunizations, and screenings conducted more frequently than recommended by federal guidelines are not considered preventive care. These services are subject to your copay, coinsurance, or deductible.

See List of Preventive Care Benefits (PDF)

Preventive Care Checklist for Women (PDF)

Preventive Care Checklist for Men(PDF)

Preventive Care Checklist for Children & Adolescents (PDF)

Consult your primary care physician to determine the appropriate screening intervals for you. For a complete list of your preventive care benefits, please see your Benefits Summary in your PEHP account.

*Note: If you get additional services during your preventive care visit, you may get charged. Ask your doctor how the visit will be billed; PEHP pays based on how it's billed.