Preventive Care Healthy Action

For LM HealthWorks Plan Members

The LM HealthWorks Plan pays most preventive care services (such as routine physical exams and cancer screenings) at 100% with no deductible or coinsurance required.

Enrolled employees and spouses may each earn a $200 HealthFund credit by completing certain preventive care exams/screenings.

Here's how:

  1. Schedule an appointment with your health care provider and get a routine physical exam or age-appropriate screening. You can search for a primary care doctor to provide preventive care services using the provider search tool (formerly DocFind).
  2. Submit your preventive care claim to the LM HealthWorks Plan. In-network providers will take care of this for you. When you use out-of-network providers, you are responsible for filing claims. Please note: Services must be appropriately listed as preventive on your claim to be eligible for the incentive.
  3. Once your preventive care claim has been received and processed by the LM HealthWorks Plan, you will automatically receive the HealthFund credit. Please allow up to 14 days from the date your claim is processed and your online Explanation of Benefits is available on the Aetna member web site for the credit to be applied to your HealthFund.

 

Eligible Services Frequency
Routine/Well Adult Physical Exam 1 exam per year
Colorectal Screening (age 50 and older)

1 every 5 years for Sigmoidoscopy and Double Contrast Barium Enema

1 every year for Fecal Occult Blood Test (FOBT)

1 every 10 years for Colonoscopy

Routine Gynecological Exam 1 exam per year
Mammogram

1 baseline age 35-40

1 per year age 40 and older

 

Appropriate preventive care depends on your age, gender and other factors. Talk with your doctor to see which preventive care services are right for you.

Please note that only one Preventive Care incentive credit may be earned per individual during the Plan Year.

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