may need advance approval from your plan. This is called a"prior authorization" or "preauthorization." Please 
contact your PCP or refer to the Evidence of Coverage (EOC) for services that require aprior authorization from the 
plan .
c
H1036234000SB23 Summary of Benefits 7H1036234000 
Covered Medical and Hospital Benefits (cont.)  
Preventive care Our plan covers many preventive services at no cost when you see 
an in-network provider including: 
•Abdominal aortic aneurysm screening