50 Please Note: Services performed as the result of medical symptoms or due to a known or suspected medical conditi on are not covered under this benefit. Such services would be considered under the related medical benefit where appropriate, subject to the applicable deductible , copayment and coinsurance for the service provided. Well child annual physical exams recomme nded in the Bright Futures Recommendations (for children from birth through age 21) are treated as preventive services, and paid at 100% when received from an in - network provider. Note : Covered preventive services and items that are required by federal law are not subject to the deductible and will be paid at 100% when received from an in - network provider. Covered preventive services received from an out - of - network provider are subject t o the out - of - network deductible and Payment Percentage. Please contact Cigna at 800 - Cigna 24 (800 - 244 - 6224) if you have any questions about what preventive services are covered, or if you need help finding an in - network provider. Routine Examinations The following charges for routine examinations are covered medical benefits under the terms of the Plan. • Charges for annual complete physical exam. • Charges for annual gynecological exam for female participants . • Charges for routine well - child visits for childre n, including developmental assessment and anticipatory guidance. Routine Immunizations The following charges for routine immunizations are covered medical benefits under the terms of the Plan. • Charges for an annual flu shot. • Charges for other medically app ropriate routine childhood and adult immunizations when recommended or provided by a physician or an Allied Health Professional, excluding immunizations solely for travel. Routine Lab and X - ray Screening The following charges for routine lab and X - ray scr eening are covered medical benefits under the terms of the Plan. • Charges for routine laboratory, electrocardiogram, and x - ray screening services ordered or performed by a physician or an Allied Health Care Professional in connection with a covered routine examination or wellness program. • Charges for an annual Papanicolaou (PAP) screening for female participant s. • Charges for an annual prostate specific antigen (PSA) screening for male participants. Routine Colonoscopy Screening This benefit applies to all covered individuals once every three (3) years beginning at age 50 or, if there is a high risk of colon cancer indicated by a physician, once every two (2) years regardless of age . The following charges for routine colonoscopy screening are covered medical benefits under the terms of the Plan.