55 Outpatient Facility Services Your Plan includes Covered Services in an: • Outpatient Hospital, • Freestanding Ambulatory Surgery Center, • Mental Health / Substance Use Disorder Facility, or • Other Facilities approved by us. Benefits include Facility and related (ancillary) charges, when proper, such as: • Surgical rooms and equipment, • Prescription Drugs, including Specialty Drugs, • Anesthesia and anesthesia supplies and services given by the Hospital or other Facility, • Medical and surgical dressings and supplies, casts, and splints, • Diagnostic services, • Therapy services. Physical Therapy Please see “Therapy Services” later in this section. Preventive Care Preventive care includes screenings and other services for adults and children. All recommended preventive services will be covered as required by the Affordable Care Act (ACA) and applicable state law. This means many preventive care services are covered with no Deductible, Copayments or Coinsurance when you use an In - Network Provider. Certain benefits for Members who have current symptoms or a diagnosed health problem may be covered under the “Diagnostic Services” benefit instead of this benefit, if the coverage does not fall within the state or ACA - recommended preventive services. Covered Services fall under the following broad groups: 1. Services with an “A” or “B” rating from the United States Preventive Services Task Force. Examples include screenings for: a. Breast cancer, b. Cervical cancer, c. Colorectal cancer - This includes the p reventive colonoscopy, anesthesia, polyp removal and pathology tests in connection with the preventive screening. It also includes a preventive screening following a positive non - invasive stool - based screening test or following a positive direct visualiza tion test (i.e., flexible sigmoidoscopy, CT colonography) , d. High blood pressure, e. Type 2 Diabetes Mellitus, f. Cholesterol, g. Child and adult obesity. 2. Immunizations for children, adolescents, and adults recommended by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention;
2026 Anthem Certificate CDHP #2 Page 55 Page 57