Today’s times have made the importance of living a healthy life clearer than ever. That’s why Thomas Health is starting a primary care health and wellness movement called Thomas Health Cares. We have a large base of primary care physicians who can see you quickly and who offer preventative health services for all ages, some of which are covered 100 percent by your insurance. Let us help you with a comprehensive evaluation that will help you take steps toward living your healthiest life.

Click on the insurance category listed below for information about preventive services that are important for you and your family’s health. Then, call us today at (304) 414-4847 to schedule an appointment with a Thomas Health provider close to your home.  We have 7 Primary Care Centers to serve you, and our providers look forward to helping you navigate the broad range of preventive services for which you are eligible.

Preventive provider visits, services and screenings that are included under your Medicare coverage include all of the following.

PROVIDER VISITS

Welcome to Medicare Preventative Visit – See a Thomas Health provider for this visit during the first 12-months under your Medicare coverage

 

Yearly Wellness Visit – After your first 12 months of enrollment, visit your Thomas Health provider for your annual Medicare Wellness Exam every year.

IMMUNIZATIONS

  • Flu Vaccine
  • Hepatitis B Vaccine
  • Pneumococcal (Pneumonia) Vaccine

SCREENINGS

  • Adnominal Aortic Aneurysm Screening – One-time coverage
  • Alcohol Misuse Screening & Counseling – One screening per year
  • Bone Mass Density Screening – One screening at least every 24 months
  • Breast Cancer Screening – One per year
  • Cardiovascular Disease Screenings – Once every five years
  • Cervical and Vaginal Cancer Screenings – Once every 24 months or once every 12 months, if high risk
  • Colorectal Cancer Screenings – Talk to your provider about your best screening option
    • Multi-Target Stool DNA Test
    • Fecal Occult Blood Test
    • Flexible Sigmoidoscopy
    • Colonoscopy
  • Depression Screening – One screening per year
  • Diabetes Screening – If at risk, up to two times per year
  • Hepatitis B Screening – If determined to be at risk
  • Hepatitis C Screening – If deemed necessary
  • HIV Screening – Once every 12 months when the patient meets certain criteria
  • Lung Cancer Screening – Once a year when the patient meets certain criteria
  • Obesity Screening & Counseling – Ask your provider for details
  • Prostate Cancer Screening – One PSA test and digital rectal exam per year
  • Sexually Transmitted Infection – One test every 12 months or at certain times during pregnancy

For complete information about your Medicare coverage, click here.

All Marketplace health plans and many other plans must cover the following list of preventive services without charging you a copayment or coinsurance. This is true even if you haven’t met your yearly deductible. Talk to your Thomas Health provider for recommendations on the frequency for each screening.

PREVENTIVE SCREENINGS FOR ALL ADULTS

  • Abdominal aortic aneurysm screening – One-time screening for men of specified ages who have ever smoked
  • Alcohol misuse screening and counseling
  • Blood pressure screening
  • Cholesterol screening – For adults of certain ages or at higher risk
  • Colorectal cancer screening – for adults 50 to 75
  • Depression screening
  • Diabetes (Type 2) screening – Adults ages 40 to 70 who are overweight or obese are eligible
  • Diet counseling – For adults at higher risk for chronic disease
  • Falls prevention (with exercise or physical therapy and vitamin D use) – for adults 65 years and over, living in a community setting
  • Hepatitis B screening – for people at high risk
  • Hepatitis C screening – For adults at increased risk, and one time for everyone born 1945–1965
  • HIV screening – For everyone ages 15 to 65, and other ages at increased risk
  • Lung cancer screening – For adults 55-80 at high risk for lung cancer because they’re heavy smokers or have quit in the past 15 years
  • Obesity screening &counseling
  • Sexually transmitted infection (STI) prevention counseling – For adults at higher risk
  • Statin preventive medication – For adults 40 to 75 at high risk
  • Tobacco use screening – For all adults and cessation interventions for tobacco users
  • Tuberculosis screening

IMMUNIZATIONS

  • Diphtheria
  • Hepatitis A
  • Hepatitis B
  • Herpes Zoster
  • Human Papillomavirus (HPV)
  • Influenza (flu shot)
  • MeasleS
  • Meningococcal
  • Mumps
  • Pertussis
  • Pneumococcal
  • RubellA
  • Tetanus
  • Varicella (Chickenpox)

In addition to the screenings and immunizations listed under Marketplace Plans for Adults, the women’s screenings listed below are generally free for in-network providers. Check with your plan provider to determine if these services will be covered at Thomas Health by your health insurance plan.

WOMEN’S HEALTH PROVIDER VISITS
Well-woman visits to get recommended services – For women under 65

PREVENTIVE SCREENINGS FOR WOMEN

  • Anemia screening
  • Breast cancer genetic test counseling (BRCA) – For women at higher risk
  • Breast cancer mammography screenings – For every 1 to 2 years for women over 40
  • Cervical cancer screening
  • Domestic and interpersonal violence screening and counseling – For all women
  • Gestational diabetes screening – For women 24 to 28 weeks pregnant and those at high risk of developing gestational diabetes
  • Hepatitis B screening – For pregnant women at their first prenatal visit
  • Human Papillomavirus (HPV) DNA test with the combination of a Pap smear – Every 5 years for women 30 to 65 who don’t want a Pap smear every 3 years
  • Maternal depression screening – For mothers of infants at 1, 2, 4, and 6-month visits
  • Osteoporosis screening – For women over age 60 depending on risk factors
  • Pap test (also called a Pap smear) – Every 3 years for women 21 to 65
  • Preeclampsia prevention and screening – For pregnant women with high blood pressure
  • Rh incompatibility screening – For all pregnant women and follow-up testing for women at higher risk
  • Tobacco use screening, including expanded tobacco intervention & counseling for pregnant tobacco users
  • Urinary tract or other infection screening

Most marketplace health plans must cover a set of preventive health services for children at no cost. Check with your plan provider to verify full coverage by a Thomas Health provider.

PREVENTIVE SCREENINGS FOR CHILDREN

  • Alcohol, tobacco, and drug use assessments – For adolescents
  • Autism screening – For children at 18 and 24 months
  • Behavioral assessments – For children ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years
  • Bilirubin concentration screening – For newborns
  • Blood pressure screening – For children ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years
  • Blood screening – For newborns
  • Cervical dysplasia screening – For sexually active females
  • Depression screening – For adolescents beginning routinely at age 12
  • Developmental screening – For children under age 3
  • Dyslipidemia screening – For all children once between 9 and 11 years and once between 17 and 21 years, and for children at higher risk of lipid disorders ages: 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years
  • Hearing screening – For all newborns; and for children once between 11 and 14 years, once between 15 and 17 years, and once between 18 and 21 years
  • Height, weight and body mass index (BMI) measurements – For children ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years
  • Hematocrit or hemoglobin screening – For all children
  • Hemoglobinopathies or sickle cell screening – For newborns
  • Hepatitis B screening
  • HIV screening – For adolescents at higher risk
  • Hypothyroidism screening – For newborns
  • Lead screening – For children at risk of exposure
  • Obesity screening and counseling
  • Phenylketonuria (PKU) screening – For newborns
  • Sexually transmitted infection (STI) prevention screening – For adolescents at higher risk
  • Tuberculin testing – For children at higher risk of tuberculosis ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years
  • Vision screening – For all children

IMMUNIZATIONS

For children from birth to age 18, vaccine doses, recommended ages, and recommended populations vary. Visit a Thomas Health provider to ensure that your child’s immunization plan is on track.

  • Diphtheria, Tetanus, Pertussis (Whooping Cough)
  • Haemophilus influenza type b
  • Hepatitis A
  • Hepatitis B
  • Human Papillomavirus (HPV)
  • Inactivated Poliovirus
  • Influenza (flu shot)
  • Measles
  • Meningococcal
  • Pneumococcal
  • Rotavirus
  • Varicella (Chickenpox)
  • Iron supplements for children ages 6 to 12 months at risk for anemia

West Virginia’s Medicaid program provides coverage for the following preventive health services. Please contact your Medicaid plan provider for information regarding out-of-pocket expenses.

PROVIDER VISITS

  • Certified pediatric & family nurse practitioner services
  • Emergency hospital services

PREVENTIVE SERVICES

  • Early periodic screening, diagnostic and treatment services for children
  • Family planning services
  • Laboratory & x-ray services
  • Tobacco cessation counseling for pregnant women

OTHER WELLNESS SERVICES

  • Alcohol & drug treatment
  • Chiropractic services
  • Hearing aids for children
  • Prescriptions & medication therapy management
  • Physical & mental rehabilitative services
  • Autism spectrum disorder services

For more complete information about West Virginia Medicaid and the health services it covers, click here.

While Medicaid insures many children in West Virginia, some children are also eligible to participate in the Children’s Health Insurance Program, more commonly known as CHIP.  Medicaid is intended to provide health benefits to the poorest children in the state. CHIP expands health insurance coverage to children in families who have incomes above the Medicaid eligibility threshold who do not have commercial insurance. Services provided through CHIP are generally comparable to those offered under the Medicaid program, however the breadth of coverage for CHIP services is determined by each state.

CHIP works with managed care organizations (MCO). MCOs are health care providers or a group of medical service providers contracted with insurers and self-insured employers to provide a wide variety of managed health care services to enrolled workers through participating providers. Each MCO has different tiers, which determine copayment amounts. Contact your CHIP provider to determine copayment amounts for covered services. 

PROVIDER VISITS
One physician’s office visit a year for a preventive check-up is covered for all insured children ages 2 through 18.  Infants under age 2 are covered for more frequent checkups as recommended by the AAP guideline.

PREVENTIVE SERVICES:

  • Immunizations
  • Nutritional education
  • Vision services (annual exams & eyewear)
  • Well-baby & well-child exams – Children should have routine well checks according to the guidelines set forth by the American Academy of Pediatrics. In addition, West Virginia children are expected to have a well-child or HealthCheck exam before entering public preschool classes or kindergarten.
    • Height & weight measurement
    • Blood pressure checks
    • Physical exams
    • Developmental/behavioral assessment
    • Age-appropriate immunizations as indicated by your medical provider
    • Objective vision & hearing screening BMI calculation
    • Lead risk screening
    • Hearing Screening

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