Preventive care rider

Your plan covers physicals, screenings, vaccinations and other services listed in the Preventive Health Care Guidelines, but because your plan is "grandfathered" (not required to follow the guidelines of the Affordable Care Act):

• You may have a copayment for some preventive care services provided by your primary care physician (PCP) or referred by your PCP.
• Some services may not be covered at all by your plan, even when they are listed in the Guidelines.

Note: Maternity services are not considered preventive care and have their own coverages and copays. See your coverage documents for details.