Many plans offer eligible preventive care at little or no cost, as long as you visit an in‑network provider. Always review your coverage to understand what’s included and when recommended tests or screenings should be scheduled, and feel free to tell your PCP that you would like to know if they are recommending any labs or tests that would add cost to an otherwise low or no-cost visit.
An annual wellness visit is a yearly check‑in with your PCP to discuss your health, review your medical history and explore services that can help you stay well. During the visit, your provider will check things like your blood pressure, height and weight, and ask questions to understand your risk for certain health conditions. They may recommend screenings or tests based on your needs. It’s also your chance to ask questions - remember, you and your provider are partners in your healthcare.
Find an in-network PCP in Blueprint Portal.
How to prepare for your annual wellness visit
Before your appointment, taking a few moments to prepare can help you get the most out of your visit. Here’s what you may want to bring:
- Your member ID card and photo ID. A digital version of your ID card is available in Blueprint Portal.*
- Your personal medical history and any relevant family health history.
- Notes about any changes you've noticed in your health, including when they began and what's different now.
- A list of your current prescriptions including the doses, how often you take them and who prescribed them. Also, any information on over-the-counter products, vitamins or supplements you’re taking.
You can bring any health questions, concerns or symptoms you want to talk about. Just remember that discussing certain medical issues may lead your provider to order additional tests or services, which could be billed separately if they aren’t part of your annual wellness visit.
* Note: Availability of digital member ID cards varies by health plan.
A wellness visit is generally considered preventive care and may be covered at little or no cost. But if you talk with your provider about a health issue or symptom, and it requires additional testing or labs, then part of the appointment could be billed as a regular office visit and your no-cost wellness visit is no longer free. It’s important to understand the difference between preventive services and diagnostic tests. If your provider orders a screening and you’re unsure whether it’s preventive or related to a specific concern, it’s okay to ask why the test is being done. You may still need the test, but if it’s tied to a symptom, it will be considered diagnostic and will add cost to your low or no-cost wellness visit.
Preventive screenings look for diseases or conditions before there are symptoms or signs. These occur at certain ages. The idea is that when you catch and treat a disease early, it will be easier to manage or eliminate. Preventive screenings play an important role in protecting your health, and many are covered at little or no cost to you under your plan.
Diagnostic tests are done when you and your provider know you have a health problem and you need to know the cause. As an example, women get regular mammograms as a preventive screening. If something is found in a preventive mammogram, the screening is still at no cost. However, if the provider schedules a follow-up mammogram six months later to re-examine that change, it would be used to diagnose a symptom and wouldn’t be preventive.
The easiest way to find out what preventive screenings or labs your plan covers at no cost is to review your schedule of benefits in the coverage and copay section of Blueprint Portal or call the customer service number on your member ID card before you see your provider. You can also find your schedule of benefits in your Blueprint Portal account under the Coverage & Copays tab. Your provider may suggest some of the screenings below.
While some screenings or labs are considered preventive, others are considered general bloodwork and may not be covered through your annual preventive visit. To avoid a surprise bill, be sure to ask your provider to only order labs that will be fully covered by your health plan unless they are medically necessary.
Preventive screenings and labs for men and women
Stay on top of your health with recommended screenings and tests tailored to your age, risk factors, and lifestyle.
Blood pressure screening
All adults
At least annually and at every doctor visit if you have high blood pressure
Diabetes screening
Adults age 35-70
At least annually for individuals who:
- Are overweight
- Have a family history of diabetes
- Are physically inactive
- Have a history of high blood pressure
Osteoporosis
Women: 65 and older and
Men: 70 and older
Every two years
Colon cancer screening
Adults age 45-75
You and your doctor can decide which one of these screenings is right for you:
- Fecal occult blood test every year
- Sigmoidoscopy every 5 years
- Colonoscopy every 10 years
- CT Colonography (virtual colonoscopy) every 5 year
76 and older
Ask your doctor
Preventive screenings for men
Men can take charge of their health with routine screenings designed to catch potential issues early and support long-term well-being.
Cholesterol screening
Adults age 20-35
Ask your doctor
35 and older
Every 5 years (if normal results)
Prostate cancer
Adults age 50-69
Annually
Adults age 70 and older
Ask your doctor
Preventive screenings for women
Women can support lifelong health with preventive screenings that help detect changes early and guide informed care decisions at every stage.
Cervical cancer pap smear
Adults age 21-65
Every three years after becoming sexually active; not needed after a total hysterectomy
66 and older
Ask your doctor
Cholesterol screening
Adults age 20-45
Ask your doctor
Adults age 45 and older
Every 5 years (If normal results)
Mammogram
Adults age 40 and older (consult your healthcare provider for exceptions)
Every one to two years
Adults age 75 and older
Ask your doctor
Note: Preventive screenings and age recommendations may vary by plan, be sure to check your schedule of benefits in Blueprint Portal before scheduling screenings.
Sources: Centers for Disease Control and Prevention; Centers for Medicare and Medicaid Services; National Institutes of Health; U.S. Department of Health and Human Services; U.S. Preventive Services Task Force
Immunizations
Immunizations are an essential part of preventive care and one of the safest ways to protect yourself, your family and your community from serious diseases. You can get a wide range of vaccines during your annual wellness visit for little or no cost and participating in‑network pharmacies carry several of the same ones for your convenience.
Flu shots
An annual flu vaccine is recommended for everyone 6 months and older. Certain groups are more likely to get very sick from the flu, including adults 65 and older, infants under 12 months, pregnant women and individuals with weakened immune systems or chronic health conditions like diabetes, asthma, cancer or autoimmune disorders.
Although the flu vaccine can’t prevent every case of the flu, it greatly reduces the risk of severe symptoms and hospitalization. It also provides important protection for people who cannot be vaccinated.