Table with glasses and medial equipement

100% Covered

Quick Stats


Blue Cross and Blue Shield of Nebraska
Group #: 101498
NEtwork BLUE Network
Pharmacy Network: Network C
Drug List: PDL 10 (Formerly "BCBSNE Standard Formulary")


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Preventive Care Services

Preventive care services are covered at 100% when they are obtained from a network provider, as long as no diagnosis is made. Please see the chart below for more information on recommended preventive care services.

The services listed are general recommendations. Your doctor may recommend different frequency or timing based on your personal or family history.

History, Physical Examination and Assessment At each preventive care visit
  • Blood Pressure
  • Height and Weight (BMI)
  • Depression Screening
  • Tobacco, Alcohol or Drug Abuse Screening
  • Sexual Wellness and Disease Screening
Diabetes Screening At each preventive care visit
Cholesterol Screening Every five years beginning at age 35
Colorectal Cancer Screening 50 years of age and over; annually with fecal occult blood test; every 5-10 years with colonoscopy
Cervical Cancer Screening (Pap smear) Women annually at age 18 or age of sexual activity and every 1-3 years thereafter
Breast Cancer Screening (Mammogram) Women age 40 and older; every 1-2 years thereafter
Osteoprorosis Screening Age 65 and older; once every two years thereafter
Sexually Transmitted Disease Screening Annually based on risk
Pregnancy-related Screenings Ask your doctor about additional services recommended during your pregnancy
  • Bacteria in the urine
  • Folic acid supplementation
  • Hepatitis B screening
  • Rh compatibility
  • Iron deficiency screening
  • Gestational diabetes
Risk of Falling Assessment Age 65 and older


Tetanus and Diphtheria (Td/Tdap) Every 10 years
Pneumococcal (Pneumonia) One dose
Influenza (flu) Annually
Human Papilloma Virus (HPV) 3-dose series before age 25
Zoster (Shingles) One dose, age 60 or over
Meningococcal Certain high risk groups based on medical, occupational, lifestyle, or other indicators
Hepatitis B or Hepatitis A Persons at risk or catch-up series
Varcella (Chicken pox) Catch-up if needed

Other Services

Breastfeeding Support, Supplies, and Counseling One breast pump per pregnancy
Contraceptive Methods and Counseling Varies based on contraceptive methods
Diet Counseling 100% paid as needed

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The information on this page is a partial description of benefits, limitations, exclusions, and other provisions of the group benefits provided by Woodmen of the World Life Insurance Society (WoodmenLife). If there is a difference between the information in this summary and the plan document for each plan, the plan documents govern. Eligibility requirements apply to each of the benefits offered, criteria may include employment status and/or individual qualifications. For more detailed information, refer to the Summary Plan Description of each plan. WoodmenLife may amend these plans at any time. The description of the plan is not a guarantee of benefits and should not be construed as such.

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