30 2024 Evidence of Coverage for WA PEBB Kaiser Permanente Senior Advantage Medical Benefits Chart Services that are covered for you What you must pay when you get these services Screening and counseling to reduce alcohol misuse We cover one alcohol misuse screening for adults with There is no coinsurance, copayment, or Medicare (including pregnant women) who misuse alcohol deductible for the Medicare-covered but aren't alcohol dependent. screening and counseling to reduce If you screen positive for alcohol misuse, you can get up to alcohol misuse preventive benefit. four brief face-to-face counseling sessions per year (if you're competent and alert during counseling) provided by a qualified primary care doctor or practitioner in a primary care setting. Screening for lung cancer with low-dose computed tomography (LDCT)† For qualified individuals, a LDCT is covered every 12 months. Eligible members are: People aged 50–77 years who have no signs or symptoms of lung cancer, but who have a history of tobacco smoking of at least 20 pack-years and who currently smoke or have quit smoking within the last 15 years, who receive a written order for LDCT during a lung cancer There is no coinsurance, copayment, or screening counseling and shared decision-making visit that deductible for the Medicare-covered meets the Medicare criteria for such visits and be furnished counseling and shared decision-making by a physician or qualified non-physician practitioner. visit or for the LDCT. For LDCT lung cancer screenings after the initial LDCT screening: The members must receive a written order for LDCT lung cancer screening, which may be furnished during any appropriate visit with a physician or qualified non- physician practitioner. If a physician or qualified non- physician practitioner elects to provide a lung cancer screening counseling and shared decision-making visit for subsequent lung cancer screenings with LDCT, the visit must meet the Medicare criteria for such visits. † Your provider must obtain prior authorization from our plan. * Your cost-sharing for these services or items doesn't apply toward the maximum out-of-pocket amount. kp.org