services at no cost when you see  
an in-network provider including: 
•Abdominal aortic aneurysm  
screening $0 copay  
Any additional preventive services  
approved by Medicare during the  
contract year will be covered. You do not need areferral to receive covered services from plan providers. Certain procedures, services and drugs 
may need advance approval from your plan. This is called a"prior authorization" or "preauthorization." Please