| HMO | Health Promotion / Disease Prevention Activities |
| Aetna US Healthcare | Covers: Health education and health care information literature at HMO’s discretion.
Cost Sharing: A small charge applies for some materials. |
| Blue Cross Blue Shield | Covers: Vision and hearing screenings. |
| CIGNA / Healthsource | Covers: Health education programs provided by CHCNC. |
| Doctors Health Plan | Covers: Health education programs provided by Doctors, health risk assessment, work site wellness, programs for healthy living and educational programs developed to support the medical management of certain conditions including diabetes and asthma. |
| Generations | Covers: Health education classes and services when deemed medically necessary and with prior approval by Generations. |
| Optimum Choice | Excluded. |
| PARTNERS | Covers: Nutritional counseling when ordered by PCP and approved by the plan.
Limits: Nutritional counseling limited to 3 visits per 12 consecutive months for services following a newly diagnosed condition or significant worsening of a chronic condition. Excludes: Printed health education materials. |
| Coventry/Principal Health Care of the Carolinas | Covers: Health education services when provided in a participating physician’s office or other participating provider setting. Health education services include instructions on achieving and maintaining physical and mental health, and preventing illness and injury.
Excludes: Nutritional counseling unless medically necessary and approved by Coventry/Principal. Excludes food or food supplements. |
| QualChoice | Excludes: Instructional or educational programs, such as, but not limited to, childbirth classes, nutritional counseling, vocational training and testing, or weight maintenance programs. |
| The Wellness Plan of North Carolina, Inc. | Covers: Vision and hearing screenings by the member’s PCP. Also covers nutrition counseling when approved. |
| United HealthCare | Covers: General patient education programs when medically necessary and approved in advance by UHC. |
| WellPath | Covers: Certain health education and disease management services at HMO’s discretion. |