Frequently Asked Questions - Preventive Benefits

Why does Caterpillar offer preventive benefits?
We are committed to providing all employees and their families with high quality benefits. We want our employees and their families to live healthy lifestyles. Promoting prevention and early detection of disease is critically important to us all.  


With regard to preventive care, who determines what Caterpillar covers?
Caterpillar uses the Grade A and B recommendations set forth by the U.S. Preventive Service Task Force (USPSTF), which means that the services are clinically determined to enhance both quality of life and life expectancy. The list of Grade A and B recommendations can be found at uspreventiveservicestaskforce.org.


What is the U.S. Preventive Service Task Force?
The USPSTF is a multidisciplinary panel of independent experts, which has been in existence since 1984. It was commissioned by the U.S. Public Health Agency to conduct rigorous, impartial review of the scientific literature regarding medical services such as screening tests and counseling. The USPSTF is regarded as the premier source worldwide on the effectiveness of the broad range of clinical services. The task force regularly updates and publishes their recommendations as new knowledge becomes available. Visit the organization’s website for more information: uspreventiveservicestaskforce.org


Do all plans provide preventive care at the same level?

For Caterpillar Inc. Employee Health, Life and Disability Benefit Program plan options, preventive care services are covered at 100% by the Program if you use a network provider and the primary purpose of your visit is the delivery of such preventive care service. If you use a non-network provider, you will be subject to the applicable co-insurance (for PPO or CDHP options):

  • For those in the Caterpillar NetWork or UnitedHealthcare network plans:
    Employees must use a network provider if they are in a network plan to receive the maximum benefit. If an employee in a network plan goes to a non-network provider, he/she will have to meet the deductible and then once that is met, the charge for a preventive service will be considered at 50% of Usual and Customary.
  • For those in out-of-area plans with no network requirements:
    If an employee is in an out-of-area plan, covered preventive care will be paid at 100% of Usual and Customary charges.
  • Blue Cross Blue Shield EPO
    Preventive care services are covered at 100% if you use a network provider. To learn what preventive services are covered at 100%, visit www.bcbsil.com/caterpillar or call 1-844-228-2227.


GLOSSARY OF TERMS

Preventive Care Services – The Program covers preventive care services in accordance with the Patient Protection and Affordable Care Act, as modified by the Healthcare and Education Reconciliation Act of 2010. For additional information preventive care services covered by the Program, please visit:
www.healthcare.gov/center/regulations/prevention.html
www.uspreventiveservicestaskforce.org
www.cdc.gov/vaccines

Immunizations – Benefits are payable in any Plan Year for immunizations that have in effect a recommendation from the Advisory Committee on Immunization Practice for Disease Control and Prevention if such recommendation went into effect at least one year prior to the beginning of such Plan Year.

Well Child Preventive Care – Benefits are payable in any Plan Year for infants, children and adolescents for preventive care and screenings provided for in guidelines supported by the Health Resources and Services Administration if such guideline is issued at least on year prior to the beginning of such Plan Year.

Well Woman Preventive Care – Benefits are payable in any Plan Year for preventive care and screenings for women provided for in guidelines supported by the Health Resources and Services Administration if such guideline is issued at least one year prior to the beginning of such Plan Year.

Grade A and Grade B Recommended Services – Benefits are payable in any Plan Year for items or services that have in effect a rating of A or B in the current recommendation of the United States Preventive Services Task Force if such recommendation went into effect at least one year prior to the beginning of such Plan Year. It is advisable to periodically review the Grade A and Grade B recommendations, as they do change.