Understanding and using your insurance: Preventive care

Elderly patient talking with her doctor

Preventive care keeps you healthy, prevents illness and detects disease in the early stages –when it’s easier to treat. Here are suggested guidelines for screenings and checkups for healthy adults. Individuals with a family history of certain diseases and those with other risk factors should discuss preventive health measures with their primary care doctor. To receive these preventive services, make an appointment with your doctor and bring this checklist to talk about which screenings you may need.

These services may be covered at no out of pocket cost to you when you visit a PCP in your health plan’s network. For complete benefit details, refer to your plan’s Individual Medical Policy.

Healthy adult preventive healthcare guidelines

Screening Frequency Things to know
Physical exam Routinely Exam should include measuring your weight, height, and body mass index (BMI). Talk to your doctor about your physical activity.
Cholesterol/lipid screening Every 5 years A 9-12 hour fast is required. If you have cardiovascular problems or diabetes, you may need a test every year.
Diabetes screening and tests Every 3 years, more if at risk If you have diabetes, these tests are recommended yearly: HbA1c test, LDL cholesterol, kidney test and retinal or dilated eye exam
Blood pressure 1-2 years if normal range (120/80) May need to be more often if you have high blood pressure or diabetes
Bone density screening for osteoporosis Periodically as directed by doctor; around 65 years or older May need frequent screening after a bone fracture or if you’re at high risk for osteoporosis
Eye exam Every 2-4 years to age 64, then every 1-2 years after Eye exams for glaucoma and macular degeneration—to common age-related conditions.
Colon cancer screenings For ages 50 and up Talk to your doctor about your risks and which test and schedule is best for you; most recommend a yearly fecal occult blood test, a flexible sigmoidoscopy every five years, or a colonoscopy every 10 years
Flu Vaccination Annually for ages 6 months and older The flu vaccine protects against the influenza viruses that will be the most common during the upcoming flu season.

Women only

Screening Frequency Things to know
Mammogram Every 1-2 years for women age 40 and up Younger women should follow their doctor’s recommendations. Talk to your doctor about clinical breast exams.
Pap test and pelvic exam Every 3 years or more as doctor directs Talk to your doctor about your risks and which Pap testing schedule is best, especially if you’ve had a hysterectomy or are 65 or older.
Human papillomavirus (HPV) vaccine 3 doses for females age 11-12 Talk to your child’s doctor about the vaccine, which protects against cancers caused by HPV infection.

Men only

Screening Frequency Things to know
Prostate exam Determined by your doctor Talk to your doctor about your risks and which test and schedule is right for you. Exams include a digital rectal exam and a prostate-specific antigen test (PSA).

Source: www.cdc.gov

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