Preventive Care Guidelines for Illinois Commercial, Marketplace and Medicare plans
BCBSIL publishes and disseminates evidence-derived Preventive Care Guidelines based upon the recommendations of recognized sources such as professional medical associations, specialty societies, professional consensus panels, national task forces, and governmental entities. The guidelines are designed to improve physician/practitioner awareness of (and compliance with) effective clinical preventive care, to improve patient education and to increase the percentage of members who receive recommended clinical preventive care services. These guidelines are current and have been reviewed and approved by the BCBSIL Clinical Quality Committee.
If you have any questions about the guidelines, or wish to provide feedback, this can be done by contacting the Quality Improvement Department at 312-653-3465.
The guidelines are not all inclusive and do not cover all possible circumstances, but should be considered as a summary of basic preventive services for these populations:
- Children from birth to 17 years
- Adults 18 years and older
- Adults 65 years and older
Preventive Care Guidelines for Illinois Medicaid Plans
The Preventive Care Guidelines for Illinois Medicaid plans are adopted by BCBSIL through the Quality Assurance Committee and are focused on primary prevention. These are strategies that have been shown to reduce the likelihood of future adverse outcomes in individuals prior to the onset of a symptomatic disease. Services such as education and counseling, screening tests and immunizations are primary preventive services. These services can help avoid serious health problems, and are designed to improve physician/practitioner awareness of (and compliance with) effective clinical preventive care. The primary purpose is to improve patient education and to increase the percentage of members who receive recommended clinical preventive care services. If you have any questions about the guidelines, or wish to provide feedback on the guidelines, this can be done by contacting the Quality Improvement Department.
These Guidelines are not all inclusive, but rather should be used as a summary of basic preventive services for these populations:
- Children from birth to 21 years of age
- Adults 18 years and older
- Adults 65 years and older
- Perinatal Care