Gynecological Coverage

You are covered at the in-network level of benefits for gynecological exams and services when performed by a participating Ob/Gyn or your Primary Care Physician.

You can visit a participating Ob/Gyn for related treatment and services without a referral form from your PCP.

Mammography Coverage

Your Horizon POS plan covers mammography screenings. To be covered at the in-network level, please have your services performed by a participating provider and at a participating facility. Your Horizon POS plan covers mammography screenings as outlined below:

• Women can have their first (baseline) screening between the ages of 35 and 39.
• One annual screening for women age 40* and over. Your doctor may recommend a different mammography screening schedule if you are considered to be at high risk for breast cancer.

You do not need a referral form to receive a mammogram; however, you still need a prescription from your PCP or participating Ob/Gyn to present to a participating hospital or participating imaging center.

*A woman who is under 40 years of age and has a family history of breast cancer or other breast cancer risk factors may have a mammogram examination at such age and intervals as deemed medically necessary by the woman’s health care provider.