| HMO | Annual Physicals (well-baby, well-child) |
| Aetna US Healthcare | Covers: Well child care, routine physicals, ear, hearing and eye examinations.
Excludes: Special medical reports not directly related to treatment of the member, e.g., employment or insurance physicals, reports prepared in connection with litigation. |
| Blue Cross Blue Shield | Covers: Well-baby care and routine office visits, periodic health checks, as well as exams required for marriage, schools, employers and athletic teams.
Cost Sharing: Copayments apply. |
| CIGNA / Healthsource | Covers: Well child care and physical examinations.
Excludes: Routine physical exams and testing required for marriage, or by third parties, such as schools, employers, athletic teams or judicial bodies.. Also excludes exams and vaccinations required to travel abroad. |
| Doctors Health Plan | Covers: Well-child care; physical exams.
Cost Sharing: Copayments may apply. Excludes: Physical examinations required by third parties such as insurers, schools, employers, camps, athletic teams or judicial bodies. Also excludes examinations required to travel abroad. |
| Generations | Covers: Well-child care; one complete physical examination per benefit period; hearing screening and audiometric testing by PCP; routine vision screenings by PCP for children up to 18.
Excludes: School physicals, premarital exams and physical exams for employment, sports or insurance. No cost sharing. |
| Optimum Choice | Covers: Well child care and periodic health assessments considered medically necessary.
Cost Sharing: Copayments apply. Excludes: Physical examinations for employment, insurance, school, camp, travel, or governmental licensure, unless such exams can be obtained within the limits of the periodic health assessment. |
| PARTNERS | Covers: Well-child care and physical examinations according to plan-prescribed frequency guidelines. The number of covered well-child visits and physical examinations varies by age. Also includes vision and hearing screening by PCP up to age 18.
Excludes: Physical examinations required by third parties such as insurers, schools, employers, camps, athletic teams or judicial bodies. Also excludes examinations required to travel abroad. |
| Coventry/Principal Health Care of the Carolinas | Covers: Pediatric and well-baby care, routine physicals, and annual gynecological examination.
Excludes: Physical examinations for employment, school, camp, sports, licensing, insurance, adoption or marriage or other examination ordered by a third party. |
| QualChoice | Covers: Physical examinations, including well child care and all physicals for dependents through age 18.
Excludes: Exams for obtaining or maintaining employment, insurance or professional or other licenses. |
| The Wellness Plan of North Carolina, Inc. | Covers: Periodic health exams, preventive examinations performed by the PCP for men, women, and children.
Excludes: Routine physical exams and testing required for marriage, or by third parties, such as schools, employers, athletic teams or judicial bodies, including court-ordered services except when medically necessary. Also excludes exams and vaccinations required to travel abroad. |
| United HealthCare | Covers: Well-child care and annual routine medical and vision screenings.
Cost Sharing: Copayment determined by type of physician or provider providing the care. Excludes: Physical exams or testing for purposes relating to career, education, travel, employment, insurance, marriage, or adoption. Also excludes exams or testing for judicial or administrative proceedings or orders; those conducted for medical research or to obtain or maintain any type of license. |
| WellPath | Covers: Well-baby and well-child care, routine sight, speech and hearing screenings for children, routine physicals for adults.
Cost-sharing: Applicable office visit copayment applies. |