UVA Health Plan Preventive Information

UVA Health Plan Preventive Information

Preventive care is given to you when you're symptom-free and have no reason to believe you might be unhealthy. Preventive care is often given as part of a routine physical or checkup. Diagnostic care is what you receive when you have symptoms or risk factors and your doctor wants to diagnose them. During a provider's visit, whether it's a physical or medical office visit, if the service is used to diagnose, monitor or treat an illness or injury, then copays, coinsurance and deductibles will apply.

Read more about the preventive services offered to UVA Health Plan members: 

For additional details, contact Aetna One Advocate team Phone: 800.987.9072

Aetna Clinical Policy Bulletin - Provides a detail of services and procedures Aetna considers medically necessary, cosmetic, or experimental and unproven. 

Discount Information

FAQs

  • Why did I get a charge for a lab test that the doctor ordered during my yearly physical exam?

    While physical exams that are coded as “preventive” by your participating provider will be processed at 100%, if there are additional tests that are not coded as a “preventive” test (i.e. submitted with a medical condition such as history of high blood pressure), the tests will go towards your deductible and coinsurance as a diagnostic test, even if the tests are done during your annual exam. There are specific lab tests that may be designated as preventive.

  • I had a mammogram and Ultrasound completed during the same visit. Why am I charged for the ultrasound?

    Mammograms are part of Aetna's preventive care services and covered at 100%.

    Breast Ultrasounds though useful are not used as routine screenings, they are considered diagnostic and not preventive. The cost will go towards your deductible and coinsurance. 

    Aetna follows American Cancer Society Recommendations

    • Women between 40 and 44 have the option to start screening with a mammogram every year.
    • Women 45 to 54 should get mammograms every year.
    • Women 55 and older can switch to a mammogram every other year, or they can choose to continue yearly mammograms. Screening should continue as long as a woman is in good health and is expected to live at least 10 more years.