you can complete your screening at your primary care physician's office.
What do i do?
Schedule an appointment with your Primary Care Physician to have a preventive screening completed.
If you are covered under the Plan and have not had a preventive screening done in 2019, your screening should be covered at 100%.
If you have already completed a preventive screening in 2019, you may use those results. Your doctor must complete and sign the Medical Care Provider Health Screening Authorization Release Form in order for it to be processed.
Download and print a Medical Care Provider Health Screening Authorization Release Form and take it to your appointment.
Complete Part One of the form and sign on the Participant Signature line.
Your doctor must complete Part Two and sign on the Medical Care Provider Signature line.
Keep a copy of the form for your records and return a copy of the completed and signed form to The Plan Office -
By Fax: 502-423-8567
By Mail: 10503 Timberwood Circle, Suite 200, Louisville, KY 40223