Preventive Services, Definitions | Member Services

Preventive Services

Top 3 Things You Should Know

  1. You’re 100% covered. If you see a Network provider, getting defined preventive services are free to you. WEA Trust follows federal guidelines for defined preventive services, outlined by the U.S. Preventive Services Task Force
  2. Labs may not be covered. Receiving other services during the same visit as a preventive services visit may be subject to out-of-pocket cost. See our FAQs below for details.
  3. Using preventive services is a good investment! Preventive services help you stay healthy. Plus, studies show that if a majority of people use preventive services, it saves the country billions of dollars.




Men & Women

Q:Abdominal Aortic Aneurysm

One-time screening for men ages 65 and older who have ever smoked

Q:Alcohol Misuse

Screening and counseling

Q:Colorectal Cancer

Screening for adults between the ages of 45 and 75, or for individuals under 45 with a family history of colon cancer


Screening for adults age 40-75

Q:Diabetes Type 2

Screening for asymptomatic adults with sustained high blood pressure

Q:Hepatitis B

Screening in adults at higher risk of infection

Q:Hepatitis C

Screening in adults between the ages of 50 and 60, and those at higher risk of infection


Screening for all adults at higher risk

Q:Lung Cancer

Annual Screening with low-dose computed tomography for adults ages 50-80 who have ever smoked

Q:Preventive Office Visit

Such as an annual physical exam, which may include:

  • Aspirin use counseling for men and women of certain ages

  • Assessment and management to prevent falls in adults 65 and older

  • Blood Pressure screening

  • Depression screening

  • Diet counseling for adults at higher risk for chronic disease

  • Counseling for diet and exercise to prevent cardiovascular disease

  • Obesity screening and counseling

  • Counseling for minimizing risks of skin cancer in adults under age 24

  • Counseling for adults at higher risk of Sexually Transmitted Infection (STI)

  • Well woman visit to obtain women's preventive services


Screening for adults at higher risk

Q:Tobacco Use

Screening and interventions for all adults


Recommendations vary for doses, ages, and populations:

  • Hepatitis A
  • Measles, Mumps, Rubella
  • Hepatitis B
  • Meningococcal
  • Herpes Zoster
  • Pneumococcal
  • Human Papillomavirus
  • Tetanus, Diphtheria, Pertussis
  • Influenza
  • Varicella

Vaccine information for "Medicare Prime" members:

    In a doctor's office:
    Medicare Part B covers the following immunizations
  • Influenza (the flu)
  • Pneumonia
  • Hepatitis B (if you are at medium to high risk)
  • Immunizations due to exposure to a disease/condition, illness or injury (e.g. tetanus)

    In a pharmacy
    Medicare Part D covers the following immunizations
  • Zoster (shingles)
  • Tdap (tetanus, diphtheria, pertussis)
  • If you still have a balance due, simply fill out our Member Reimbursement Claim Form, along with an original itemized bill from your provider, and we will cover the remainder of your costs.



Q:Anemia Screening

On a routine basis during pregnancy


Urinary tract or other infection screening in pregnant women


Screening and genetic test counseling for women at higher risk for certain cancers

Q:Breast Cancer Mammography

Screenings every 1 to 2 years for women over 40. 

Please note: 3D mammograms are covered when done in conjunction with a 2D mammogram.

Q:Breast Cancer Preventive Medication

Counseling about risk-reducing medication for women at higher risk


Interventions to support/promote breastfeeding. This includes coverage for manual and electric breast pumps. Hospital-grade and hands-free models are not covered. 

Q:Cervical Cancer

Screening once every rolling 3 years. (3 years + 1 day)


Screening for sexually active women and/or women at higher risk of infection


Approved by the FDA and requiring a prescription

Q:Domestic violence

Screening and counseling

Q:Folic Acid Supplements

For women who may become pregnant

Q:Gestational Diabetes

Screening for pregnant women


Screening for all women at higher risk of infection

Q:Hepatitis B

Screening at first prenatal visit


Testing for all pregnant women regardless of risk status


Testing one time every 5 years for women 30-65


Screening for women 65 and older or women under 65 that meet additional risk criteria

Q:Pre-eclampsia prevention

Counseling on use of aspirin by pregnant women at higher risk

Q:Rh Incompatibility

Screening and follow-up testing for women at higher risk


Screening for all pregnant women regardless of risk status

Q:Tobacco Use

Expanded counseling for pregnant women

Q:Well Woman

Annual visit to obtain women’s preventive services


Children & Adolescents

Q:Alcohol and Drug Use

Assessments for adolescents


Screening for children between their 9 month to 30 month doctor visits



Q:Cervical Dysplasia

Screening for sexually-active females

Q:Congenital Hypothyroidism

Screening for newborns


Preventive medication for the eyes of all newborns


Screening for all newborns

Q:Hematocrit or Hemoglobin



Or sickle cell screening for newborns

Q:Hepatitis B

Screening for adolescents at higher risk for infection


Screening for adolescents at higher risk


Screening for children at risk of exposure

Q:Newborn Blood Screening


Q:Preventive Office Visit

Such as a well-child visit, which may include:

  • Annual Preventive Visit
  • Blood Pressure screening
  • Depression screening for adolescents at higher risk
  • Developmental screening for children under age 3, and surveillance throughout childhood
  • Recommendation for fluoride chemoprevention supplements for children without fluoride in their water source
  • Height, Weight, and Body Mass Index measurements
  • Recommendation for iron supplements for children ages 6 to 12 months at risk for anemia
  • Medical History
  • Obesity screening and counseling
  • Oral Health risk assessment for young children
  • Recommendation for vision and hearing screening for children ages 3 to 5 years to detect amblyopia or its risk factors
  • Counseling on minimizing risks for skin cancer
  • Tobacco use intervention

Q:Sexually Transmitted Infection (STI)

Prevention counseling and screening for adolescents ages 11 to 21 at higher risk


Testing for children at higher risk of tuberculosis


For children from birth to age 18—recommendations vary for doses, ages, and populations

  • Diphtheria, Tetanus, Pertussis
  • Influenza
  • Measles, Mumps, Rubella
  • Hepatitis A
  • Meningococcal
  • Hepatitis B
  • Pneumococcal
  • Human Papillomavirus
  • Rotavirus
  • Inactivated Poliovirus
  • Varicella
  • Haemophilus Influenzae Type b

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List of Definitions

Visit: An appointment with the provider

Service: Often performed during a visit, like an exam, labs, x-ray or counseling

Routine Regularly scheduled. Routine does not necessarily mean preventive.

Preventive services: Exams, tests, or procedures that help keep track of your health and wellbeing. You receive these services to prevent future health problems. You do not have signs or symptoms. 

Diagnostic Services: Services that evaluate new or established concerns. You have signs or symptoms, or an existing health issue is being monitored. Your deductible, coinsurance and copay might apply.