Medical cost sharing membership is designed to help with the costs of unexpected illness or injury. Expenses for wellness/maintenance activities (whether conventional or integrative in nature) are generally not shareable (e.g. routine physicals, checkups, flu shots, long-term maintenance prescriptions).
There are, however, a few specific exceptions which will have a $0 IUA. These include (1) Colonoscopy, to screen for colorectal cancer, for persons age 50 and older, (2) Mammography to screen for breast cancer, for women age 40 and older (for eligible screenings not more than every 1-2 years as determined by a physician), and (3) routine childhood vaccines.
Routine diagnostic care when medically indicated (high risk circumstance, family history, etc) are shareable after the member has met their IUA. For example, an accelerated schedule of colonoscopies if there is a prior history of polyps or a family history of colon cancer.
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