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Medicare HMO Blue Medicare HMO Blue Medicare HMO Blue
ValueRx (HMO) PlusRx (HMO) FlexRx (HMO-POS)
Preventive Care You pay nothing You pay nothing In-network:
Our plan covers many Our plan covers many You pay nothing
preventive services, preventive services, Out-of-network:
including: including: $65 copay or 20%

• Abdominal aortic • Abdominal aortic of the cost, depending on
the service
aneurysm screening aneurysm screening
• Alcohol misuse • Alcohol misuse Our plan covers many
counseling counseling preventive services,
• Bone mass • Bone mass including:
measurement measurement • Abdominal aortic
• Breast cancer screening • Breast cancer screening aneurysm screening
(mammogram) (mammogram) • Alcohol misuse
• Cardiovascular disease • Cardiovascular disease counseling
(behavioral therapy) (behavioral therapy) • Bone mass
• Cardiovascular • Cardiovascular measurement
screenings screenings • Breast cancer screening
• Cervical and vaginal • Cervical and vaginal (mammogram)
cancer screening cancer screening • Cardiovascular disease
• Colorectal cancer • Colorectal cancer (behavioral therapy)
screenings screenings • Cardiovascular
(Colonoscopy, (Colonoscopy, screenings
Fecal occult blood Fecal occult blood • Cervical and vaginal
test, Flexible test, Flexible cancer screening
sigmoidoscopy)* sigmoidoscopy)* • Colorectal cancer
• Depression screening • Depression screening screenings
• Diabetes screenings • Diabetes screenings (Colonoscopy,
• HIV screening • HIV screening Fecal occult blood
• Medical nutrition • Medical nutrition test, Flexible
therapy services therapy services sigmoidoscopy)*
• Obesity screening and • Obesity screening and • Depression screening
counseling counseling • Diabetes screenings
• Prostate cancer • Prostate cancer • HIV screening
screenings (PSA) screenings (PSA) • Medical nutrition
• Sexually transmitted • Sexually transmitted therapy services
infections screening infections screening • Obesity screening and
and counseling and counseling counseling
• Lung cancer screening • Lung cancer screening • Prostate cancer
(low dose computed (low dose computed screenings (PSA)
tomography (LDCT)) tomography (LDCT)) • Sexually transmitted
• Tobacco use cessation • Tobacco use cessation infections screening
counseling (counseling counseling (counseling and counseling
for people with no for people with no • Lung cancer screening
sign of tobacco-related sign of tobacco-related (low dose computed
disease) disease) tomography (LDCT))

*If any other medical condition including polyp or other tissue is found and removed during the
procedure this would be considered minimally invasive surgery.

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