You have the opportunity to earn two wellness discounts on your medical plan premiums.
- Tobacco discount: If you (and your spouse, if applicable) have been tobacco free for the last six months, you will qualify for a $25 per pay period discount on your medical rates. To receive the tobacco discount, you will need to attest to being tobacco free when going through the enrollment process on the Paychex Enrollment Portal. You (and your spouse, if applicable) will have two chances during the year to qualify: January 1 and July 1.
- Preventive care discount: If you (and your spouse, if applicable) have had your preventive exam in the past 12 months, you will qualify for a $10 per pay period discount on your medical rates. Wellmark of Iowa will automatically confirm that you received your preventive visit. If Wellmark of Iowa is unable to verify your (and your spouse’s, if applicable) preventive visit, you will need to provide proof. Remember, preventive exams are covered 100% through your medical plan.
What is a preventive health exam?
You hear all the time that you should go to the doctor to get your annual “preventive health exam” or “physical.” Getting your annual physical/preventive health exam can help to identify any health concerns that may become bigger problems later on. But, what does this exam actually include?
The following FAQs will help you know what to expect when you visit the doctor.
What is usually included in a preventive health exam/physical?
Generally your doctor will focus on a few specific areas:
- History – You can discuss any specific concerns you have or issues you have noticed. Your doctor may discuss lifestyle behaviors such as smoking, drinking, diet, and exercise. Your personal and family medical history will be updated as well.
- Vital signs – Your doctor will check your blood pressure, heart rate, respiration rate, and temperature.
- General appearance – Your doctor may be able to get a lot of information just by talking with you and watching you. Things such as memory, skin health, and ability to walk are just a few areas that fall under this category.
- Heart exam – Your doctor will listen to your heart with a stethoscope to detect any abnormalities that could lead to things such as heart disease.
- Lung exam – Your doctor should also listen to your lungs to detect any signs of lung disease.
- Head and neck exam – When the doctor asks you to open your mouth and say, “ahh” he or she is checking your throat and tonsils. Your doctor may also check your ears, eyes, and nose to assess overall health.
- Abdominal exam – Your doctor will use multiple methods to check your abdomen and other vital organs including listening with a stethoscope and tapping to detect tenderness.
- Neurological exam – Reflexes, balance, muscle strength, and mental state may be checked.
- Extremities exam – Your doctor may check your joints for any significant changes or abnormalities.
- Immunizations – Your doctor may need to give you specific immunizations for conditions such as the flu, tetanus, etc. These are usually based on age and health history.
- Laboratory tests – Your doctor may decide to do specific lab tests based on your age and gender.
Is my preventive health exam/physical covered under my health plan?
If you are covered under one of the three health plans offered through Siegwerk, you will be able to have one preventive exam and one gynecological exam per calendar year at no cost to you, as long as you go to a doctor who is “in network.” One mammogram is also covered per calendar year at no cost. Please confirm with your doctor that your exam will be coded as “preventive” to make sure you do not pay anything!
Why did I receive a bill after my preventive health exam when it should be covered at 100%?
These exams are focused on prevention, not treatment. If a new health issue is discovered and the doctor actually spends a lot of time discussing treatment of the health issue, he or she may bill part of the exam as preventive and part as treatment. The portion specific to preventive would be no cost to you and the portion specific to treatment would mean you might either pay a copay or it would go to your deductible depending on which plan you are enrolled in.
Again, make sure to discuss with your doctor whether your exam will be coded as preventive so you do not have any unexpected bills later on!
What is a well-child exam?
Well-child exams should be done more frequently when your child is young. These exams include:
- Vaccinations needed
- Physical examination to detect any problems with growth and development
- Vision and hearing tests
Well-child care is covered 100% through Wellmark of Iowa through age 7 under your Siegwerk health plan.
What services are considered “preventive?”
Review a list of services considered “preventive” from Healthcare.gov. You can also view a list of preventive services from Wellmark of Iowa.
What is the difference between preventive health exams and diagnostic exams?
- Preventive exams are designed to prevent illness or detect problems early on before they need actual treatment.
- Diagnostic exams or diagnostic care involves treating or diagnosing a problem you are having.
The medical plans offered by Siegwerk cover preventive care at 100%. You will have to pay for diagnostic exams because they involve actual treatment of a specific condition.
Please make sure to communicate with your doctor about whether your exam is preventive or diagnostic so you will not be surprised!
The EAP, provided by ICAS, is a free, completely confidential benefit to help you and family members living in your household through life’s challenges. Siegwerk employees in the US and around the world have access to expert guidance and specialist support on all sorts of issues, from everyday matters to more serious wellbeing problems. Assistance from trained experts is available 24 hours a day, 7 days a week, 365 days a year in your local language.
The EAP provides:
- Practical guidance and support on legal, financial, family, personal, and work matters.
- Online health and wellbeing resources.
- Referrals to local experts as neded.
- Counseling for emotional and psychological support (available by telephone, video conference, or in person).
Reach out for a little assistance today
Call 800-634-6433 or visit the ICAS website.
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