Wellness Information for Health Plan Members

The purpose of this program is to provide coverage for regularly scheduled physical exams and certain preventive screening tests/procedures performed not more than once per year to detect illnesses before you are having symptoms or problems.  Based upon your age and gender certain screening tests/procedures are recommended to be done regularly.  This program is not meant to pay for tests or procedures that your doctor orders when you are ill or when you are having medical problems.  Those are considered diagnostic rather than routine screening tests or procedures and should be covered according to the rules of your Health Plan option

The documents to be given to your health care provider contain multiple pages. It is important to print and give your provider all the pages provided for the preventive services coverage.

Click on the link below to access required documents.

Letter to Physician

A special claim form is no longer required. Providers must include the appropriate procedure codes and wellness diagnosis code when submitting their bill to ensure correct claim payment.

• Provider memo and Covered Preventive Services
   

Colonoscopy- Eligibility for Procedures Scheduled Through IGRF

• Retirees and their spouses who are age 45 to age 65 and enrolled in the Health Plan
• Surviving spouses who are age 45 to age 65 and enrolled in the Health Plan
• You will be notified by IGRF the month before your birthday.

Not eligible: Those covered under Marathon Plan for Medicare Participants or COBRA members of the Health Plan.

Once you've received notification, call the IGRF coordinating center at 1-800-403-4683, ext. 307 to see if you qualify. Not everyone qualifies for a screening. Certain health conditions may permanently exclude you from this program including, but not limited to: Inflammatory Bowel Disease (Ulcerative Colitis and Crohn's Disease), a personal history of colon cancer, and other diseases of the colon which require regular colonoscopies for follow-up. Personal history of colon polyps may also exclude you from the screening program. You will need to contact IGRF for further information.

You must contact IGRF to schedule an appointment with a network doctor in your area who can perform the procedure. Failure to contact IGRF will result in non-payment under this program.

To cancel a colonoscopy scheduled through the wellness program contact IGRF at least *72 hours, excluding weekends and holidays, prior to the procedure. Missing a scheduled colonoscopy without contacting IGRF in advance may result in loss of eligibility in the program.
Additional cancellation instructions will be provided in the prep instructions received from IGRF.
*Some IGRF providers have requested more advanced notice for cancellation. If your procedure has been arranged through one of these providers, IGRF will inform you when more advance notice for cancellation is required.
 

Colonoscopy- Eligibility for Procedures Scheduled Through the Health Plan

As of January 1, 2007, screening colonoscopies are also covered under the Health Plan for eligible Health Plan members. If you are participating in the Health Plan, you may decide to arrange your screening colonoscopy through the Health Plan when there is no IGRF provider in your area. Should you choose to arrange your screening colonoscopy through the Health Plan, the rules of the Health Plan including co-insurance, deductibles and network requirements will apply, and it is recommended that you contact your Health Plan Claims Administrator prior to scheduling the procedure.