Preventive

Trinity Health provides preventive care benefits to associates enrolled in an NGS American administered medical plan.*

If you’re enrolled in Trinity Health's traditional PPO coverage, the preventive care you receive from an in-network provider will be paid in full, subject to your regular co-payment. However, if you use an out-of-network provider, benefits will be paid up to the reasonable and customary allowance at the applicable co-insurance rate, after your annual deductible is satisfied.

If you’re enrolled in Trinity Health’s Personal Care Account PPO, the plan will pay 100 percent of your preventive care costs when you use in-network providers. Because these services are not subject to deductibles or co-payments, you pay nothing out-of- pocket. However, if you decide to receive your preventive care from an out-of-network provider, services will be paid at 100% of the reasonable and customary allowance.

Preventive Care Overview

* Preventive care benefits are not available to certain associate groups. Please refer to your Summary Plan Description for plan coverage specifics.

Weight Management / Smoking Cessation | Claim Form

Associates and their dependents who are enrolled in an NGS-Administered medical plan, as part of their preventative care coverage, are eligible for weight-loss and smoking cessation treatments as outlined below.

Weight Management
Covered non-surgical weight-loss expenses along with the existing benefits for bariatric surgery, the plan will cover additional services for non-surgical weight loss treatment. Benefits, which are payable up to 80 percent to an annual benefit maximum of $500, include:
> Outpatient counseling or therapy,
> Office visits rendered by a licensed physician for the treatment of weight loss,
> Lab services performed during a course of treatment, and
> Services for weight loss rendered by nationally recognized programs such as Jenny Craig, Weight Watchers, and LA Weight Loss.

Weight-loss expenses that are NOT covered:
>Services administered exclusively through an Internet-based forum,
>Medication or injection expenses for weight loss, unless otherwise covered for an unrelated medical condition,
> Charges for food or nutritional supplements unless included in the initial program fee,
>· Charges for over-the-counter diet aids,
> Health clubs or exercise equipment,
>Services or programs that are not approved in the United States, and
>Charges in connection with acupuncture, hypnotism or biofeedback training.

Smoking Cessation
Smoking cessation treatments, which are payable up to 80 percent to an annual benefit maximum of $500, include:
> Outpatient counseling or therapy,
> Office visits rendered by a licensed physician for the treatment of smoking cessation, and
> Lab services performed during a course of treatment.

Smoking cessation expenses that are NOT covered
>Services administered exclusively through an Internet-based forum,
> Medication or injection expenses for smoking cessation, unless otherwise covered for an unrelated medical condition,
>Charges for over-the-counter smoking cessation aids,
>Services or programs that are not approved in the United States, and
> Charges in connection with acupuncture, hypnotism or biofeedback training.

Weight Management / Smoking Cessation Claim Form

Well-Baby / Well-Child Preventive Care Visits

Pediatric well-baby and well-child visits are part of an overall preventive care program that is important for raising healthy children. These visits are most frequent when the child's development is most rapid.

During a typical well-baby visit, the infant's growth and development is assessed so that any abnormalities may be addressed early. The doctor will perform a physical examination, paying special attention to whether the infant is meeting the normal developmental milestones. The baby's height, weight and head circumference is recorded on a graph, which the physician keeps with the infant's medical records.

Each well-child visit also will include a complete physical examination. Height, weight, and other important information is determined and recorded. Hearing, vision, and related tests will be a part of some visits.

Well-baby and well-child visits also present key opportunities for communication with the physician. The doctor will provide parents with information about normal development, nutrition, general care, sleep, safety, immunizations, the latest infectious diseases that are "going around," and other important advice. Parents have an opportunity to ask questions or inform the doctor of any concerns that they may have.

In addition to the child immunization record and preventive care visit record schedules provided here, the American Academy of Pediatrics recommends that first-time parents, those with high-risk pregnancies, and parents who wish to discuss other common issues (feeding, circumcision, etc.) schedule a visit with a pediatrician before the baby is born.

Adult Preventive Care Visits

Every day, you have a chance to make good choices about your health. Most people recognize that behaviors like eating healthy foods, getting sufficient physical exercise, and not smoking are essential for keeping well. But did you know that having regular medical checkups - or preventive care visits - is one of the most important things you can do to safeguard your health?

Preventive care is any medical examination, test, screening, or other activity that focuses on wellness, health promotion, and other measures that reduce the likelihood of illness or injury.

The main focus of preventive care is to reduce the likelihood of major preventable diseases - such as cardiovascular disease or cancer - through early discovery of risks or symptoms so that any necessary lifestyle changes or treatments can begin when conditions are easier to treat.

There are three levels of preventive care, all of which are important components of disease prevention and health maintenance:

> Primary prevention includes interventions that can completely prevent the disease in people at risk. One example is immunizations against certain vaccine-preventable diseases, such as measles or tetanus.
> Secondary prevention identifies established risk factors for disease. Measuring blood pressure, checking cholesterol, and performing Pap tests for cervical cancer are examples in which identifying abnormal results can lead to effective interventions that may prevent serious illnesses from developing.
> Tertiary prevention is a process for optimizing health once a disease has been diagnosed. For example, a management plan may be devised to prevent a person with heart disease from having another heart attack.

You can use the adult immunization record and preventive care visit record to help you plan for and keep track of your preventive medical care.

Adult Immunization Record
Adult Preventive Care Visit Record
Preventive Care Overview