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Health Programs

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Health and Wellness Programs

Treating yourself right isn't a fad, it's a good habit. And it's a habit anyone can pick up. Let our Wellness programs improve the areas of your life that could use a boost.

Preventive Care

A lifetime of good health starts with quality medical care throughout your life. Thanks to the Affordable Care Act (ACA), this care is now within the reach of all Americans. ACA requires health plans to eliminate cost sharing and cover preventive care services recommended by the U.S. Preventive Services Task Force (USPSTF), guidelines specifically issued for women and adopted by Health Resources & Services Administration (HRSA), the Advisory Committee on Immunization Practices, and the Bright Futures Guidelines of the Academy of Pediatrics.

The following recommendations are general guidelines for all ages and should not dictate the care you receive. Your doctor will let you know what tests and exams you may need based on your specific risk factors and overall health.

    • Guidelines may change throughout the year based on new or revised laws and/or regulations, and additional guidance.
    • Services must be billed with a primary diagnosis of preventive, screening, counseling, or wellness, if applicable, to qualify and other restrictions may apply.
    • In addition to the services listed below, you may have additional preventive care benefits covered under your health plan at 100%. Check your plan documents for details.
    • Grandfathered plans (a plan that hasn’t changed since 2010) may have costs. See your plan documents to find your specific coverage and costs.
    • Talk to your health care provider about a proper schedule of check-up visits.

Preventive Care versus Diagnostic Care

Preventive Care

Comprehensive evaluation to prevent health problems; you do not have symptoms or other abnormal studies suggesting abnormalities

Diagnostic Care

Medical care to treat or diagnose a problem, to monitor existing problems, or follow up on abnormal test results. 

Disease Management

Get free assistance with chronic health and access to care

Managing a health condition can be challenging. To make it a little easier, Baylor Scott & White Health offers employees and dependents of Scott & White Health Plan disease management services through the Baylor Scott & White Quality Alliance Comprehensive Care Management team.

A care manager can help you stick with your care plan, manage your prescriptions, and schedule your doctors’ appointments. Care managers may even reach out to your physician to help facilitate conversations about your health concerns.

Care managers will reach out to you if you’ve been identified as having a chronic health condition such as asthma, diabetes, COPD, or a variety of other conditions that warrant focused care. Or you may prefer to contact a care manager at your convenience by calling the Health Access Center at 844-279-7589. The Health Access Center can also help you find Tier 1 providers in the Scott & White Health Plan.

Complex Case Management

This program is for members who have chronic conditions or complex care needs.  A nurse case manager will work with members, families, and the physician to create a plan to meet the member’s ongoing complex care needs. Case managers advocate for members and assist them with setting goals and making a personal plan to improve their health.  They also can assist with arrangements for necessary services.  Case managers answer questions and provide education to help members have a better understanding of their condition and plan of care.

The purpose of the program is to help members get the best possible results and the greatest value from their health plan. Participation is voluntary. There is no additional cost to members for this program.

For more information, please request a screening to see if Complex Case Management is the right program for your needs.

Maternity Topics and MOMS Program

Scott and White Health Plan supports new and expecting parents. In the MOMS Program, licensed professionals provide important information and resources for new moms and dads, and answer any questions they may have as they plan for their newborn.

If you are planning to breastfeed your newborn and would like information regarding our breast pump program, or information on contracted Durable Medical Equipment (DME) providers, please contact the MOMS Program team at 888-316-7947. We will provide a breast pump to new mothers through one of our contracted DME providers as early as the third trimester. Only breast pumps obtained through a contracted DME provider will be reimbursed.

For more information, please request a screening to see if Complex Case Management is the right program for your needs.