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Cost-sharing for preventive and nonpreventive services

September 1, 2011

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As previously communicated in Partners in Health Update, AmeriHealth announced there is no member cost-sharing ($0) for certain preventive services provided to certain members. These new cost-sharing rules are mandated by the Federal Health Care Reform act known as the Patient Protection and Affordable Care Act of 2010. The $0 copayment does not apply to problem-focused (i.e., nonpreventive) services. If a member is seen for both preventive and nonpreventive services during the same visit, cost-sharing may apply.

For questions regarding member benefits, log on to the NaviNet? web portal and select Member Eligibility and Benefits Inquiry from the Plan Transactions menu. You may also use the Provider Automated System by calling 1-800-275-2583.

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