At AmeriHealth Administrators, our members’ health is our top priority. One important way members can stay healthy is by getting recommended preventive care. That’s why most AmeriHealth Administrators health plans fully cover recommended preventive care services at an in‑network provider or pharmacy, so members pay $0 out‑of‑pocket.
Preventive care can help prevent illness, reduce the risk of getting sick, and detect diseases early before they become more serious. This can also help members save money on overall health care costs down the road if an issue is caught early or if an immunization prevents a member from getting a serious illness.
Now is the perfect time for your employees and their families to make sure they’re up to date with their preventive care.
Prevention matters
Preventive care can include:
Check-ups: Annual physicals, gynecology well‑visits, and pediatric well‑visits
Health screenings: Blood pressure, cancer, cholesterol, depression, and diabetes
Immunizations: COVID‑19, influenza (flu), and human papillomavirus (HPV)
Medications: Certain prescription drugs and over‑the‑counter (OTC) products, such as aspirin, contraceptives, fluoride for children, tobacco interventions, etc.
Therapy and counseling: Nutrition counseling, prevention of falls counseling, and tobacco use counseling
Preventive care recommendations are based on personal risk factors, age, and gender. Members can view this brochure to see the full list of covered preventive services for adults, women, and children.
Keep up with immunizations
A key part of preventive care is getting recommended immunizations. Vaccines are the best way to protect children, adolescents, and adults against infectious diseases. This time of year is especially important for your employees and their families to keep up with the following seasonal vaccines:
- COVID-19: COVID‑19 can be very contagious and spread quickly. It can cause older people and those with underlying medical conditions like cardiovascular disease, diabetes, chronic respiratory disease, or cancer to develop serious illness. Vaccines and boosters are available to help reduce the risk of severe disease, hospitalization, and death. All members can get their COVID‑19 vaccine at no cost when obtained from an in-network doctor’s office. Members with coverage that includes pharmacy benefits can access the COVID‑19 vaccine at local independent and national chain pharmacies through their pharmacy benefit.
- Flu: Getting an annual flu shot is one of the most important steps you can take to protect your health and well‑being. Each year, thousands of people are hospitalized because of complications from the flu. The Centers for Disease Control and Prevention (CDC) recommends that everyone 6 months of age and older, especially if they’re at high risk of flu complications, get a yearly flu shot. Members can get their flu vaccine at no cost at their doctor’s office, a retail health clinic, an in‑network pharmacy, or a wellness event. In addition, members who pay for their flu shot out of pocket can get reimbursed for up to $50 per member, per vaccine. Members can access the Flu Vaccine Reimbursement Form by logging in at the website on their ID card.
- Respiratory Syncytial Virus (RSV): RSV is a common respiratory virus that usually causes mild, cold‑like symptoms. It can be more serious in infants and older adults, who are more likely to develop severe RSV and need hospitalization. AmeriHealth Administrators members who meet the CDC criteria can get the RSV vaccine (for adults) and monoclonal antibody products (for infants and young children). This includes infants under eight months of age, regardless of risk, who are born during the current RSV season or entering their first RSV season, children eight to 19 months of age who are at an increased risk of severe RSV and who are entering their second RSV season, adults 60 years of age and older, and pregnant individuals at 32 through 36 weeks gestational age. Members with coverage that includes pharmacy benefits can access the RSV non‑pediatric immunization/vaccine at no cost at an in‑network pharmacy when meeting the same criteria as outlined above for preventive immunization. Otherwise, regular prescription drug cost-share will apply.
Get started
Members should talk to their doctor about which preventive services are appropriate for them based on age and gender, and then schedule an appointment, if needed.
Members should have their ID cards handy for doctor visits, at the pharmacy, and to contact our Customer Service team at any time. Share this flyer with your employees so they can learn how to access their ID cards digitally.
Healthy You! is a monthly newsletter of reliable health information designed to educate, engage, and enlighten. Featuring information on trending topics along with nutritious recipes, Healthy You! can be used to encourage better health among your fellow employees and their families. View the current issue.
This content was originally published in the AmeriHealth Administrators Insider email newsletter.