Know Your Benefits

State and School Employees' Health Plan in Association with Blue Cross and Blue Shield Wellness / Preventive Program

Motivating Mississippi - Keys to living Healthy, is the Plan's wellness and health promotion program. Through this program, adult participants ages 18 and older can complete a HealthQuotient (HQ) health risk assessment and receive a personalized wellness plan, access to lifestyle improvement programs, and access to personal wellness coaches.  These services are provided by WebMD, the Plan's wellness and health promotion vendor, at no cost to the participant.

In addition to the benefits described above, the Plan provides the Following:

Wellness / Preventive Coverage for Adults

Benefits will be provided at 100% of the allowable charge for up to two (2) office visits and certain diagnostic tests and immunizations per calendar year. These diagnostic tests and immunizations are based on the participant's age and gender. These services are not subject to the calendar year deductible. Wellness and preventative care benefits are only provided when a network provider renders the service and the wellness services are filed with a wellness diagnosis. Go to http://knowyourbenefits.dfa.ms.gov for a list of covered preventative services.

Wellness/Preventive Prescriptions

In accordance with health care reform, benefits for the items listed are provided at 100 percent of the allowable charge and not subject to the calendar year or prescription drug deductible. A prescription is required for all preventive medications that are provided at 100 percent of the allowable charge.

• Aspirin for male participants ages 45 - 79 years old; female participants ages 13 - 79 years old.
• Generic Statin (Lovastatin) for participants without a history of cardiovascular disease (CVD), 40 - 75 years of age with one or more CVD risk factors with a 10-year cardiovascular event risk factor of 10 percent or greater.
• Bowel Prep medications for colonoscopy procedures in participants age 50 years and older.
• Fluoride supplements for children ages 6 months up to age 5 years.
• Infant Eye Ointment for the prevention of gonococcal eye infections (for newborns) up to age 3 months.
• Iron Supplements for children ages 6 - 12 months old.
• Certain preventive medications for women age 35 and older who are at an increased risk for breast cancer.

A complete list of the covered preventive prescriptions can be found at https://www.myprime.com/ or can be obtained by calling Prime.