Breast health screening tests See also the “Mammogram and Digital Breast Tomosynthesis (DBT)” benefit for more information about breast health screening tests. The tests listed below may be covered for diagnostic purposes as indicated under plan medical policy. Services covered • Members age 40 or older: Breast health screening tests, as well as digital mammograms, are covered as preventive. • Members under age 40: See the “Mammogram and Digital Breast Tomosynthesis (DBT)” benefit for how preventive breast health screening tests are covered for high-risk members. Services not covered The procedures listed below are not covered by the plan when they are performed supplementary to digital mammography for screening purposes for members with or without dense breasts. Non-high-risk members: • Automated Breast Ultrasound (ABUS) • Handheld Ultrasound (HHUS) • Magnetic Resonance Imaging (MRI) High-risk members: • Automated Breast Ultrasound (ABUS) • Handheld Ultrasound (HHUS) Care Gap Closure Program The Care Gap Closure Program encourages members to receive recommended preventive and chronic care services and screenings, also known as “gaps in care.” These include screenings for cancer, diabetes, and more at no cost to you. This support includes helping members find a PCP, making appointments, ensuring members understand their benefits, and providing members ongoing support through case management, as needed. Contact UMP Customer Service for more information. Care management Regence care management supports the unique needs of members with chronic, serious, or sudden illness or injury and prioritizes those needs by providing personalized services that enhance well-being. Care management teams can help with: • Advocating for members and their support systems and improving care through close collaboration with providers. • Assisting members as they navigate the health care system, including helping members find preferred providers and facilities, and supporting members transitioning to different levels of care. • Educating members about their care options, benefits, and coverage, as well as helping members make educated decisions regarding their health care. • Supporting members with coordination of care needs. We offer a single-nurse model dedicated to delivering personalized and holistic medical and behavioral health support to each member and their family. Once a member is engaged in the care management program, they may be assigned a case manager who is a licensed social worker or registered nurse. Regence case managers work closely with a member and their providers to help meet treatment plan goals and improve a member’s overall health. 44 2024 UMP CDHP (PEBB) Certificate of Coverage