Health Insurance
100% Covered
Provider
Blue Cross and Blue Shield of Nebraska
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Group #101498
NEtwork BLUE Network
1-888-592-8961
Pharmacy Network
Network C
Drug List
PDL 10 (Formerly “BCBSNE Standard Formulary“)
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Preventive Care Services
Preventive care services are covered at 100% when they are obtained from a network provider, as long as no diagnosis is made. Please see the chart below for more information on recommended preventive care services.
The services listed are general recommendations. Your doctor may recommend different frequency or timing based on your personal or family history.
| History, Physical Examination and Assessment | At each preventive care visit |
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Blood Pressure Height and Weight (BMI) Depression Screening Tobacco, Alcohol or Drug Abuse Screening Sexual Wellness and Disease Screening |
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| Diabetes Screening | At each preventive care visit |
| Cholesterol Screening | Every five years beginning at age 35 |
| Colorectal Cancer Screening | 50 years of age and over; annually with fecal occult blood test; every 5-10 years with colonoscopy |
| Cervical Cancer Screening (Pap smear) | Women annually at age 18 or age of sexual activity and every 1-3 years thereafter |
| Breast Cancer Screening (Mammogram) | Women age 40 and older; every 1-2 years thereafter |
| Osteoprorosis Screening | Age 65 and older; once every two years thereafter |
| Sexually Transmitted Disease Screening | Annually based on risk |
| Pregnancy-related Screenings | Ask your doctor about additional services recommended during your pregnancy |
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Bacteria in the urine Folic acid supplementation Hepatitis B screening Rh compatibility Iron deficiency screening Gestational diabetes |
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| Risk of Falling Assessment | Age 65 and older |
Immunizations
| Tetanus and Diphtheria (Td/Tdap) | Every 10 years |
| Pneumococcal (Pneumonia) | One dose |
| Influenza (flu) | Annually |
| Human Papilloma Virus (HPV) | 3-dose series before age 25 |
| Zoster (Shingles) | One dose, age 60 or over |
| Meningococcal | Certain high risk groups based on medical, occupational, lifestyle, or other indicators |
| Hepatitis B or Hepatitis A | Persons at risk or catch-up series |
| Varcella (Chicken pox) | Catch-up if needed |
Other Services
| Breastfeeding Support, Supplies, and Counseling | One breast pump per pregnancy |
| Contraceptive Methods and Counseling | Varies based on contraceptive methods |
| Diet Counseling | 100% paid as needed |