4 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 Bone mass measurement For qualified individuals (generally, this means people at risk There is no coinsurance, copayment, or of losing bone mass or at risk of osteoporosis), the following deductible for Medicare-covered bone services are covered every 24 months or more frequently if mass measurement. medically necessary: Procedures to identify bone mass, detect bone loss, or determine bone quality, including a physician's interpretation of the results. Breast cancer screening (mammograms) Covered services include: There is no coinsurance, copayment, or • One baseline mammogram between the ages of 35 and 39. deductible for covered screening • One screening mammogram every 12 months for women mammograms. aged 40 and older. • Clinical breast exams once every 24 months. Cardiac rehabilitation services† Comprehensive programs for cardiac rehabilitation services that include exercise, education, and counseling are covered $20 per visit for members who meet certain conditions with a doctor's order. Our plan also covers intensive cardiac rehabilitation programs that are typically more rigorous or more intense than cardiac rehabilitation programs. Cardiovascular disease risk reduction visit (therapy for cardiovascular disease) There is no coinsurance, copayment, or We cover one visit per year with your primary care doctor to deductible for the intensive behavioral help lower your risk for cardiovascular disease. During this therapy cardiovascular disease visit, your doctor may discuss aspirin use (if appropriate), preventive benefit. check your blood pressure, and give you tips to make sure you're eating healthy. † 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