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Preventive Care 3/21/2024

Effective January 1, 2024, the Fund will be recognized as a “non-grandfathered” plan according to the federal law known as the Affordable Care Act (“ACA”). For dates of service on and after January 1, 2024, certain preventive care services and supplies delivered by a provider in the Fund’s medical or prescription drug retail pharmacy network (i.e., “In Network”) will be covered by the Fund at 100% with no “Cost-sharing” to Participants and Dependents covered under the Plan.

“Cost sharing” includes deductibles, coinsurance, copayments, or similar charges. “Cost-sharing” does not include premiums, balance billing amounts for out-of-network providers, or charges for services not covered by the Plan.

Preventative care services and supplies include many vaccines, physicals, tests, certain prescription drugs, and screenings for numerous conditions (including for mental health/substance abuse, and numerous women’s health and children’s preventative care services). For more information on specific listings and categories of the designated preventative services and supplies that will be covered for free after the effective date, please visit: http://www.healthcare.gov/coverage/preventive-care-benefits/

For information on the Fund's coverage, see NECA-IBEW Welfare Trust Fund Preventive Care Coverage