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Well-baby| Description of Services: | Provides coverage for recommended immunizations and the office visit at the time of the immunization. |
| Access: | Participants may make appointments directly with their network provider. |
| Provider: | Primary care network physicians |
| Eligible Participants: |
Blue Cross Blue Shield PPO
participants / dependents.
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Coverage: |
Well-Baby, Well-Child care provides coverage for recommended immunizations and the office visit at the time of the immunization. The immunization schedule is based on the recommendations of the American Academy of Pediatrics (AAP), the American Academy of Family Practice Physicians and the U.S. Task Force for Preventive Services. The plan also covers a PKU test performed at birth and a well-baby office visit with a PKU test two to three weeks following birth. The following
immunization schedule is a guide and represents the maximum number
and type of immunizations and lab tests that are covered by the Blue
Cross Blue Shield PPO Plan. Your physician may prescribe an actual
interval for immunizations, which, including initial and PKU office
visits, provides approximately eight well-baby checkups for the
baby's first year. |
| Immunizations | Ages Covered | Recommended Frequency |
| Diphtheria/Tetanus/Pertussis* | 0 to 18 | One series |
| H. influenza type B* | 0 to 18 | One series |
| Hepatitis A | 0 to 18 | One series |
| Hepatitis B | 0 to 18 | One series |
| Measles/Mumps/Rubella | 0 to 18 | One series |
| Polio | 0 to 18 | One series |
| Prevnar | 0 to 18 | One series |
| Tuberculosis Test (TB) | 0 to 18 | Once only |
| Varicella Zoster (Chicken Pox) | 0 to 18 | One series for those not previously immunized |
| Flu vaccine | 0 to 18 | Annually |
| Office Visit | Ages Covered | Recommended Frequency |
| Physical Development Assessment | 0 to 18 | Annually |
| Lab Tests | Ages Covered | Recommended Frequency |
| Cholesterol | 0 to 18 | Once only |
| Hematocrit | 0 to 18 | Annually |
| Hemoglobin | 0 to 18 | Annually |
| Urinalysis | 0 to 18 | Annually |
| Lead Screening | 2 to 6 | Once only |
| * If your doctor chooses, tetramune can be given instead of DTP and HiB | ||
Reminder: To add coverage for a newborn child, coverage must be elected within 30 days from the date of birth. Well-Baby, Well-Child Checkups One physical development assessment office visit will be covered per year. Expenses for recommended immunizations and lab tests are covered at 100%. No copay, coinsurance or deductibles apply. Services by non-network providers are covered at 100% of reasonable and customary fees. |