2024 Evidence of Coverage for UnitedHealthcare® Group Medicare Advantage PEBB Balance (PPO) Chapter 4: Medical Benefits Chart (what is covered and what you pay) 81 Services that are covered for you What you must pay when you get these services in-network and out-of-network Intensive cardiac rehabilitation services $15 copayment for each The plan covers intensive cardiac rehabilitation programs Medicare-covered intensive cardiac rehabilitative visit.†† that are typically more rigorous or more intense than cardiac rehabilitation programs. You pay these amounts until you reach the out-of-pocket maximum. There is no coinsurance, Cardiovascular disease risk reduction visit (therapy for cardiovascular disease) copayment, or deductible for We cover one visit per year with your primary care doctor to the cardiovascular disease help lower your risk for cardiovascular disease. During this preventive benefit. visit, your doctor may discuss aspirin use (if appropriate), check your blood pressure, and give you tips to make sure you’re eating healthy. There is no coinsurance, Cardiovascular disease testing copayment, or deductible for Blood tests for the detection of cardiovascular disease (or cardiovascular disease testing abnormalities associated with an elevated risk of that is covered once every five cardiovascular disease) covered once every 5 years (60 years. months). There is no coinsurance, Cervical and vaginal cancer screening copayment, or deductible for Covered services include: Medicare-covered preventive · For all women: Pap tests and pelvic exams are covered Pap and pelvic exams. once every 24 months · If you are at high risk of cervical or vaginal cancer or you are of childbearing age and have had an abnormal Pap test within the past 3 years: one Pap test every 12 months · For asymptomatic women between the ages of 30 and 65: HPV testing once every 5 years, in conjunction with the Pap test