2024 Evidence of Coverage for WA PEBB Kaiser Permanente Senior Advantage 31 Medical Benefits Chart Services that are covered for you What you must pay when you get these services Screening for sexually transmitted infections (STIs) and counseling to prevent STIs We cover sexually transmitted infection (STI) screenings for chlamydia, gonorrhea, syphilis, and Hepatitis B. These screenings are covered for pregnant women and for certain There is no coinsurance, copayment, or people who are at increased risk for an STI when the tests are deductible for the Medicare-covered ordered by a primary care provider. We cover these tests screening for STIs and counseling for once every 12 months or at certain times during pregnancy. STIs preventive benefit. We also cover up to two individual 20- to 30-minute, face-to- face high-intensity behavioral counseling sessions each year for sexually active adults at increased risk for STIs. We will only cover these counseling sessions as a preventive service if they are provided by a primary care provider and take place in a primary care setting, such as a doctor's office. Services to treat kidney disease Covered services include: $0 • Kidney disease education services to teach kidney care and help members make informed decisions about their care. • †Outpatient dialysis treatments (including dialysis treatments when temporarily out of the service area, as $0 explained in Chapter 3, or when your provider for this service is temporarily unavailable or inaccessible). • †Self-dialysis training (includes training for you and anyone helping you with your home dialysis treatments). • †Home dialysis equipment and supplies. $0 • †Certain home support services (such as, when necessary, visits by trained dialysis workers to check on your home dialysis, to help in emergencies, and to check your dialysis equipment and water supply). • †Inpatient dialysis treatments (if you are admitted as an No additional charge for services inpatient to a hospital for special care). received during a hospital stay. Refer to the "Inpatient hospital care" section of this Medical Benefits Chart for the cost- sharing applicable to inpatient stays. † 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. 1-877-221-8221 (TTY 711), 7 days a week, 8 a.m. to 8 p.m.