1. Here are suggested guidelines for screenings and checkups for healthy adults.
There are also vaccination and immunization guidelines for children and adults on
the back page. Individuals with a family history of certain diseases and those with
other risk factors should discuss preventive health measures with their primary care
physician. For complete benefit details, refer to your plan’s Certificate of Coverage or
Summary Plan Description.
Healthy adult preventive healthcare guidelines
Physical exam – Routinely. This exam should include measuring your weight, height
and body mass index (BMI). It’s also a good time to talk to your doctor about ways to
increase physical activity.
Cholesterol/lipid screening – Every five years, or more often if you’re at risk or have
above-normal levels. A nine- to 12-hour fast is required. If you have cardiovascular
problems or diabetes, you may need a test every year.
Diabetes screening and tests – Every three years, or more often if you’re at risk. If you
have diabetes, the following exams and tests are recommended each year: HbA1c test,
LDL cholesterol, kidney test and retinal or dilated eye exam.
Blood pressure – Every one to two years if normal (less than 120/80), more often if you
have high blood pressure or diabetes.
Bone density screening for osteoporosis – Periodically as directed by your doctor,
usually around age 65 or older. Some may need frequent screening after a bone fracture
or if you’re at high risk for osteoporosis.
Eye exam – Every two to four years up to age 64 and then every one to two years.
Eye exams test for glaucoma and macular degeneration – two common
age-related conditions.
Colorectal cancer screenings – Talk to your doctor about your risks and which
colorectal cancer screening test and schedule is best for you. For ages 50 and older,
most recommend an annual fecal occult blood test, a flexible sigmoidoscopy every
five years, or a colonoscopy every 10 years.
Women only
Mammogram – Every one to two years for women age 40 and older. Younger women
should follow their doctor’s recommendations. Also talk to your doctor about
clinical breast exams.
Pap test and pelvic exam – At least every three years or more often as directed by
your doctor. 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. only
Men only
Prostate exam – 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).
This material provided is a general summary and does not address all your organization’s specific issues. This
material is for informational purposes only. It is not intended or written to be used, and it cannot be used, as
legal advice or a legal opinion. It should not be relied upon in lieu of consultation with your own legal advisors.
Insurance and tax laws and interpretations of those laws are complex and subject to change. None of the
information herein is intended or written to be used, and it cannot be used, for the purpose of avoiding taxes or
penalties that may be imposed.
Preventive Health Guide
Preventive care keeps
you healthy, prevents
illness and detects
disease in the early
stages – when it’s
easier to treat.
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2. Recommended for all
Recommended for members with a high risk factor
AGE
VACCINE Birth 1 mos 2 mos 4 mos 6 mos 9 mos 12 mos 15 mos 18 mos 19-23 mos 2-3 yrs 4-6 yrs
Hepatitis B 1 dose 1 dose 1 dose
Rotavirus (RV) 1 dose 1 dose
1 dose
as needed
Tetanus, diphtheria, pertussis (DTaP) 1 dose 1 dose 1 dose 1 dose 1 dose
Haemophilus influenzae type b (Hib) 1 dose 1 dose
1 dose
as needed
1 dose
Pneumococcal 1 dose 1 dose 1 dose 1 dose 1 dose
Inactivated polio virus 1 dose 1 dose 1 dose 1 dose
Influenza 1-2 doses yearly
Measles, mumps, rubella (MMR) 1 dose 1 dose
Varicella (chicken pox) 1 dose 1 dose
Hepatitis A 2 doses 2 doses
Meningococcal 1 dose
Child
Keep a record of your immunizations and give your healthcare
providers a copy. Talk to your doctor about your risk for infection and
which immunizations you may need.
AGE
VACCINE 7-10 years 11-12 years 13-18 years
Tetanus, d iphtheria, pertusis (Td/Tdap) 1 Tdap dose if needed to catch up 1 dose 1 Tdap dose if needed to catch up
Human papillomavirus (HPV) 3 doses 3 doses if not completed
Meningococcal 1 dose 1 dose Booster at 16 or 1 dose
if not previously vaccinated
Influenza 1 dose yearly
Pneumococcal 1 dose
Hepatitis A 2 doses
Adolescent
Older children should receive Hepatitis B, polio, MMR, and chicken pox if not vaccinated or if they did not receive all recommended doses as a child.
AGE
VACCINE 19-26 years 27-54 years 55-59 years 60-64 years 65 years and up
Tetanus, diphtheria, pertussis (Td/Tdap) Boost with TD every 10 years, substitute 1 time dose of Tdap if not previously vaccinated
1 Td booster
every 10 years
Human papillomavirus (HPV) 3 doses if series
not completed
Varicella (chicken pox) 2 doses if no chickenpox history or not vaccinated
Zoster (shingles) 1 dose
Measles, mumps, rubella (MMR) 1-2 doses if no history
of the vaccine or disease
1 dose
Influenza 1 dose yearly
Pneumococcal (polysaccharide) 1 or 2 doses (for smokers and those with certain chronic conditions) 1 dose
Hepatitis A 2 doses
Hepatitis B 3 doses
Meningococcal 1 or more doses
Adult
Adult high risk can be caused by medical, occupational, lifestyle, or other indications. Source: Centers for Disease Control and Prevention.
Immunization Schedules. Retrieved Feb. 27, 2013
from http://www.cdc.gov/vaccines/recs/
Vaccination/immunization guidelines
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