Anthem Lumenos Plans - Preventive Care Benefits
Anthem's Lumenos plans cover preventive services recommended by the U.S. Preventive Services Task Force, the American Cancer Society, the Advisory Committee on Immunization Practices (ACIP) and the American Academy of Pediatrics. The Preventive Care benefit includes screenings, immunizations and other services to detect medical conditions in advance and keep you healthier in the long run.
To encourage consumers to receive the appropriate preventive services, these services are covered at 100% when received from an in-network provider. Plan deductibles and health account dollars do not apply to these services. If preventive care services are provided by an out-of-network provider, then the plan deductible and out-of-network coinsurance responsibility will apply, and health account dollars may be used to cover these costs. If you receive any of these services for diagnostic purposes - for example, a colonoscopy when symptons are present, the plan deductible and coinsurance will apply and available health account dollars may be used to cover these costs.
To allow doctors to prescribe the preventive care services appropriate for the individual consumer, frequency and age restrictions do not apply to these preventive care services.
Adult Preventive Care Benefits
The following is a list of covered preventive care services for adults:
Office Visits (for preventive physical exams
Screening Tests including:
- Eye chart vision screening (Full vision exams not included)
- Hearing screening
- Cholesterol and Lipid level screening
- Blood Glucose test to screen for Type II Diabetes
- Prostate Cancer screenings including Digital Rectal Exam and PSA test
- Breast exam and Mammography screening
- Pelvic exam, Pap test and contraceptive management for females
- Screening for sexually transmitted diseases
- HIV test
- Bone Density test to screen for osteoporosis
- Colorectal Cancer screening including Fecal Occult Blood test, Barium Enema, Flexible Sigmoidoscopy and screening Colonoscopy
- Routine Blood and urine screenings
Immunizations for:
- Hepatitis A
- Hepatitis B
- Tetanus, Diphtheria (Td)
- Varicella (chicken pox)
- Influenza (flu shot)
- Pneumococcal Conjugate (pneumonia)
- Humana Papilloma Virus (HPV)
- Measles, Mumps, Rubella (MMR)
- Meningococcal Polysaccharide
- Herpes Zoster (shingles)
Well Baby and Well Child Preventive Care Benefits
The following is a list of covered preventive care services for babies and children:
Office Visits (for preventive physical exams
Screening Tests including:
- Eye chart vision screening (Full vision exams not included)
- Hearing screening
- Screening for lead exposure
- Pelvic exam, Pap test and contraceptive management for females
Immunizations for:
- Hepatitis A
- Hepatitis B
- Diphtheria, Tetanus, Pertussis (DtaP)
- Varicella (chicken pox)
- Influenza (flu shot)
- Pneumococcal Conjugate (pneumonia)
- H.Influenza type b
- Polio
- Measles, Mumps, Rubella (MMR)
- Meningococcal Polysaccharide
- Rotavirus


