Health Insurance Information
State Health Plan
Screenings conducted by Health Promotion that can be filed with State Health Plan include the cholesterol/multichemistry, mammogram, and prostate cancer. These screening tests are covered by State Health Plan on a schedule determined by your age:
- If you are under 40 years of age you may have these screenings covered once every three years.
- If you are 40-50 years of age you may have these screenings covered once every two years.
- After the age of 50 you may have these screenings covered every year.
PLEASE NOTE! Mammography Wellness Benefit now covers 100% of allowable charges once per year for women age 40 or above. (State Health Plan)
Special notes:
- If you are 39 and have a screening test you cannot have the same test 100% covered until you are 42; similarly the same is true if you are 49.
- One year means exactly 365 days.
- You have a total of $150 of benefits each fiscal year (July 1-June 30); screenings will not be covered if you have already used the full amount.
- If you are not sure when your last screening was filed with SHP or whether you have used up your $150 you can call SHP at 1-800-422-4658.
In order to best utilize this benefit you need to keep a record of the dates of your health screenings. If you do not meet the criteria for reimbursement, you will be responsible for the payment. On your screening date, please bring your State Health Plan ID card with you.
PPO
Screenings conducted by Health Promotion that can be filed with the new PPO include the mammogram and prostate cancer. At this time, the cholesterol/multichemistry is not covered because Health Promotion is not considered "In Network." On your screening date, please bring your new PPO insurance card with you.
Medicare
If you have Medicare, Health Promotion cannot file for the multi-chemistry/cholesterol blood test or the PSA test. You may pay out of pocket at the time of the screening or have the procedure done through your physician. Mammograms through Health Promotion are covered by Medicare.
Spouses and/or significant others are eligible to participate in the screenings. However, if they are not covered with State Health Plan/PPO we will not be able to bill for screenings. The fee will be due at the time of the screening.
