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Preventive Screenings Can Save Your Life

Which screenings do you need?

Many serious illnesses have no signs in the early stages. It’s important to talk to your doctor about screenings even if you feel fine. Age, health, and family history determine which screenings you need. Check with your doctor to see which screenings are right for you.

Preventive health chart

The quick-reference chart below lists screenings your HMO plan covers. It is not a recommendation for how often to have a screening. Please talk to your doctor about what screenings are right for you. For more complete benefit information, see your Evidence of Coverage (EOC) booklet.

Annual Physical

  Explanations Your coverage Copay
Physical exam A checkup given by your doctor to help you stay healthy and identify any health issues before they become serious. Once every calendar year. $0

Cancer Screenings

  Explanations Your coverage Copay
Breast cancer A breast exam and mammogram (type of X-ray) to check for signs of breast cancer. One mammogram every 12 months—clinical breast exam once every 24 months. $0
Cervical cancer Pap test and pelvic exam to check for cervical, vaginal, and ovarian cancers. Once every 24 months, or every 12 months if at high risk. $0
Colorectal cancer Tests to find colorectal cancer early and determine, based on risk, what treatment may work best. Colonoscopy screening once every 24 months if at high risk—once every 10 years if not at high risk. $0
Prostate cancer Prostate screening by digital rectal exam and Prostate Specific Antigen (PSA) test. Once every 12 months. $0

Immunizations

  Explanations Your coverage Copay
Flu shot A shot to help prevent the flu (you need a flu shot for the current virus each year). Once per flu season (fall or winter). $0
Pneumonia A shot to prevent pneumonia. As medically necessary. $0
Hepatitis B A shot to prevent Hepatitis B. As medically necessary. $0

Sensory Screenings

  Explanations Your coverage Copay
Routine hearing exam Test to determine hearing ability. Once a year. See below*
Routine vision exam Test to determine sight. Once a year. $15
Glaucoma Test to find glaucoma, a condition that causes gradual loss of sight without warning and often without symptoms. Once every calendar year if you are at high risk for glaucoma. $0

Other Screenings

  Explanations Your coverage Copay
Cardiovascular disease testing Blood tests for the detection of cardiovascular disease. Once every 5 years. $0
Diabetes Blood tests to see if you are at risk for diabetes. Based on test results, up to 2 screenings every 12 months. $0
Osteoporosis Bone mass measurement tests (such as a DEXA scan) to see if you are at risk for broken bones. If at risk, once every 24 months or more often if medically necessary. $0
Depression Test to determine risk of depression. Once every calendar year. $0
Abdominal aortic aneurysms Ultrasound exam. Once per lifetime if at risk. $0
STIs Test to check for sexually transmitted infections (STIs). Once every 12 months, or more often if medically necessary. $0
HIV Test to check for HIV. Once every 12 months. $0

*Routine hearing exam copays: Saver $45, Basic $40, Value $25, Prime $15.

Benefit information may be different if you receive your benefits from a current or former employer.

How Our Plans Can Help

Resources & Tools

drug search
Drug Search
Use the drug search tools to find out if your drugs are covered and which tier they fall under on your plan type.
senior health library
Health Library A-Z
Tufts Health Plan has partnered with Healthwise to provide members with access to a library of high-quality content on conditions, treatments and more.
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Find a Doctor
Find a doctor within your Tufts Health Plan Medicare Preferred HMO network or your Tufts Health Plan Senior Care Options network.