Click here to read Part 1.

What is the difference between a health maintenance exam and a well-female exam?

A health maintenance exam is a complete physical, including:

• Health history
• A review of all health and lifestyle risk factors
• An exam of all systems including cardiovascular, respiratory, neurological, musculoskeletal, reproductive and behavioral
• Laboratory studies appropriate for age, risk and sex
• Discussion of recommended lifestyle changes.

These exams are recommended every five years from ages 18-39, every 2-3 years from ages 40-49, and every 1-2 years for ages 50 and over.

Well-female exams are far less extensive, limited essentially to pelvic and Pap tests, as well as your clinical breast exam. Well-female exams can be performed by your primary care provider or selected Plan OB/GYN provider.

How often should I have a well-female exam?

Well-female exams are recommended for women 18 and over. Sexually active women should have well female exams every 1-3 years. Discuss the interval that’s appropriate for you with your physician.

What if my child has already had his or her health maintenance exam this year, but is now required to have a sports physical for school?

Since your child already had a health maintenance exam, it is usually not necessary to also have a separate sports physical. In this case, have your provider complete the school’s physical form, and use the date of the previous physical examination. This should be acceptable documentation for the school’s purposes.

If there is a range recommended for an exam, how often should I schedule the exam?

Where there is a range, such as 1-2 years, talk to your physician about how often you need to have the exam.

What if my provider recommends that I have these exams more frequently?

In most cases, your benefits provide coverage for an exam to be performed once per benefit period.

If the reason for a more frequent exam schedule is due to an underlying chronic disease, benefits would apply. However, if your physician just wants you to have health maintenance exams at a more frequent rate than once per benefit period, the additional exams are not a covered benefit.

Click here to read Part 1.