I am very fortunate to have health and drug coverage through the VA. Yet, I still have a plan from SafeGuard Health. Of the three plans offered, I chose the highest plan. It includes what I consider to be a really good prescription drug plan. It allows me to see local doctors four times a year and a specialist twice a year. IMPORTANT: Safe Guard Health meets the Affordable Care Act’s (ACA) minimum requirements to cover wellness and preventative visits and procedures. Scrool down to see the extensive list of minimum requirements.

These plans are Guaranteed Issue – Available 49 States (not in VT)

What is SafeGuard Health (SGH)?

SGH is a market-based solution developed to assist individuals and families across the nation. The solution provides benefits for preventive care, copays for Primary Care and Specialist Physician visits and prescription benefits (benefits vary based on plan level selected).

How does a Member check if their physician or specialist is in-network?

Simply go to www.multiplan.com and click on “Find a provider”.
You MUST use an in-network provider to utilize the office visit copays. If you use an out-of-network provider, you will be responsible for the full cost of the visit.

Does this plan cover an annual mammogram at an imaging center (not a doctor’s office)?

SafeGuard Health will cover the screening if the claim is coded as a preventive visit. Under ACA, mammograms are covered starting at age 40. NOTE: Be sure the Doctor offices have a pre-determination, pre-authorize the procedure and confirm the procedure is coded as “preventive”.

Are there a lot of participating pharmacies on the SGH Rx drug plan?

The SGH Rx plan is accepted at over 67,000 participating pharmacies nationwide, so you are sure to find a pharmacy near yoiu. Simply present your ID card at the time of service to receive the discounted pricing.

Where can a member check SGH Rx drug pricing and locate participating pharmacies near them?

You can visit www.sghrx.com. The website has all the information you need to lookup and identify drugs, locate pharmacies and get directions, compare drug pricing and more.

What if you move to another state?

You will continue in your current plan if you move to another state. The plans are not available outside the U.S. and cannot be used while traveling or relocating outside the U.S.

Cancelation Policy

This product has a 1-year agreement in which members are unable to cancel unless they have a Qualified Event. A Qualified Event is one of the following:
• Change in legal marital status – marriage, divorce, annulment, death of a spouse or legal separation
• Change in dependent children – birth, adoption, legal guardianship or death of a child
• Loss of spousal coverage – loss of job, etc.
• Dependent children “age out” – child’s age exceeds the age limitations of the membership

What if you turn 65?

Your policy will be termed at midnight on the day of your 65th birthday.

Visit my SAFEGUARDHEALTH Enrollment Site.

Member Portal: sghmembers.com

Customer Service: (855) 978-6927.

In-Network Covered Preventive Services for Adults

1. Abdominal aortic aneurysm one-time screening for men of
   specified ages who have ever smoked
2. Alcohol misuse screening and counseling
3. Aspirin use to prevent cardiovascular disease and colorectal
   cancer for adults 50 to 59 years with a high cardiovascular risk
4. Blood Pressure screening
5. Cholesterol screening for adults of certain ages or at higher risk
6. Colorectal Cancer screening for adults 50 to 59
7. Depression screening
8. Diabetes (Type 2) screening for adults 40 to 70 years who are
   overweight or obese
9. Diet counseling for adults at higher risk for chronic disease
10. Falls prevention (with exercise or physical therapy and vitamin D
    use) for adults 65 years and over, living in a community setting
11. Hepatitis B screening for people at high risk, including people
    from countries with 2% or more Hepatitis B prevalence, and
    U.S.-born people not vaccinated as infants and with at least one
    parent born in a region with 8% or more Hepatitis B prevalence.
12. Hepatitis C screening for adults at increased risk, and one time
    for everyone born 1945-1965
13. HIV screening for everyone ages 15 to 65, and other ages at
    increased risk
14. Lung cancer screening for adults 55-80 at high risk for lung
    cancer because they’re heavy smokers or have quit in the past
    15 years.

15. Immunizations vaccines for adults – doses, recommended ages,
    and recommended populations vary:
    • Diphtheria
    • Hepatitis A & B
    • Herpes Zoster
    • Human Papillomavirus (HPV)
    • Influenza (flu shot)
    • Measles
    • Meningococcal
    • Mumps
    • Pertussis
    • Pneumococcal
    • Rubella
    • Tetanus
    • Varicella (Chickenpox)
16. Obesity screening and counseling
17. Sexually transmitted infection (STI) prevention counseling for
    adults at higher risk
18. Statin preventive medication for adults 40 to 75 at high risk
19. Syphilis screening for adults at higher risk
20. Tobacco use screening for all adults and cessation interventions
    for tobacco users
21. Tuberculosis screening for certain adults without symptoms at
    high risk

In-Network Covered Preventive Services for Children

1. Alcohol, tobacco, and drug use assessments for adolescents
2. Autism screening for children at 18 and 24 months
3. Behavioral assessments for children ages: 0 to 11 months, 1 to 4
   years, 5 to 10 years, 11 to 14 years, 15 to 17 years
4. Bilirubin concentration screening for newborns
5. Blood pressure screening for children ages: 0 to 11 months, 1 to
   4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years
6. Blood screening for newborns
7. CervicaI dysplasia screening for sexually active females
8. Depression screening for adolescents beginning routinely at age 12
9. Developmental screening for children under age 3
10. Dyslipidemia screening for all children once between 9 and 11
    years and once between 17 and 21 years, and for children at
    higher risk of lipid disorders ages: 1 to 4 years, 5 to 10 years, 11
    to 14 years, 15 to 17 years
11. Fluoride chemoprevention supplements for children without
    fluoride in their water source
12. Fluoride varnish for all infants and children as soon as teeth are
    present
13. Gonorrhea preventive medication for the eyes of all newborns
14. Hearing screening for all newborns; and for children once
    between 11 and 14 years, once between 15 and 17 years, and
    once between 18 and 21 years
15. Height, weight and body mass index (BMI) measurements for
    children ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14
    years, 15 to 17 years
16. Hematocrit or hemoglobin screening for all children
17. Hemoglobinopathies or sickle cell screening for newborns
18. Hepatitis B screening for adolescents at high risk, including
    adolescents from countries with 2% or more Hepatitis B
    prevalence, and U.S.-born adolescents not vaccinated as infants
    and with at least one parent born in a region with 8% or more
    Hepatitis B prevalence: 11-17 years

19. HIV screening for adolescents at higher risk
20. Hypothyroidism screening
21. Immunization vaccines for children from birth to age 18 – doses,
    recommended ages, and recommended populations vary:
    • Diphtheria, Tetanus, Pertussis (Whooping Cough)
    • Haemophilus influenza type b
    • Hepatitis A & B
    • Human Papillomavirus (HPV)
    • Inactivated Poliovirus
    • Influenza (flu shot)
    • Measles
    • Meningococcal
    • Pneumococcal
    • Rotavirus
    • Varicella (Chickenpox)
22. Iron supplements for children ages 6 to 12 months at risk for
    anemia
23. Lead screening for children at risk of exposure
24. Maternal depression screening for mothers of infants at 1, 2, 4,
    and 6-month visits
25. Medical history for all children throughout development ages: 0
    to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17
    years
26. Obesity screening and counseling
27. Oral health risk assessment for young children ages: 0 to 11
    months, 1 to 4 years, 5 to 10 years
28. Phenylketonuria (PKU) screening for newborns
29. Sexually transmitted infection (STI) prevention counseling and
    screening for adolescents at higher risk
30. Tuberculin testing for children at higher risk of tuberculosis ages:
    0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to
    17 years
31. Vision screening for all children

In-Network Covered Preventive Services for Pregnant Women

1. Anemia screening on a routine basis
2. Breastfeeding comprehensive support and counseling from
   trained providers, and access to breastfeeding supplies, for
   pregnant and nursing women
3. Contraception: Food and Drug Administration-approved
   contraceptive methods, sterilization procedures, and patient
   education and counseling, as prescribed by a health care
   provider for women with reproductive capacity (not including
   abortifacient drugs). This does not apply to health plans
   sponsored by certain exempt “religious employers.”
4. Folic acid supplements for women who may become pregnant
5. Gestational diabetes screening for women 24 to 28 weeks
   pregnant and those at high risk of developing gestational
   diabetes

6. Gonorrhea screening for all women at higher risk
7. Hepatitis B screening for pregnant women at their first prenatal
   visit
   8 Preeclampsia prevention and screening for pregnant women
   with high blood pressure
8. Rh incompatibility screening for all pregnant women and followup testing for women at higher risk
9. Syphilis screening
10. Expanded tobacco intervention and counseling for pregnant
    tobacco users
11. Urinary tract or other infection screening
12. Routine prenatal visits for pregnant women

Other Covered Preventive Services for Women

1. Breast cancer genetic test counseling (BRCA) for women at
   higher risk
2. Breast cancer mammography screenings every 1 to 2 years for
   women over 40
3. Breast cancer chemoprevention counseling for women at higher
   risk
4. CervicaI cancer screening
   • Pap test (also called a Pap smear) every 3 years for women 21
   to 65
   • Human Papillomavirus (HPV) DNA test with the combination of
   a Pap smear every 5 years for women 30 to 65 who don’t want
   a Pap smear every 3 years
5. Chlamydia infection screening for younger women and other
   women at higher risk
6. Diabetes screening for women with a history of gestational
   diabetes who aren’t currently pregnant and who haven’t been
   diagnosed with type 2 diabetes before

7. Domestic and interpersonal violence screening and counseling
   for all women
8. Gonorrhea screenings for all women at higher risk
9. HIV screening and counseling for sexually active women
10. Osteoporosis screening for women over age 60 depending on
    risk factors
11. Rh incompatibility screening follow-up testing for women at
    higher risk
12. Sexually transmitted infections counseling for sexually active
    women
13. Syphilis screening for women at increased risk
14. Tobacco use screening and interventions
15. Urinary incontinence screening for women yearly
16. Well-woman visits to get recommended services for women
    under 65

Visit my SAFEGUARDHEALTH Enrollment Site.