What is Your Plan for Better Health?

Make this year your best year for overall wellness. Your health benefits plan may cover early detection screenings and routine wellness exams to help you and your family stay well. Talk with your health care provider about the preventive care services that are right for you.

Child Screenings

Well-baby exam: birth, 1, 2, 4, 6, 9, 12, 15, 18 and 24 months. Infants discharged less than 48 hours after delivery, need a visit 2 to 4 days after birth. In addition, a visit with a pediatrician before the baby is born is recommended for first-time parents, those with high-risk pregnancies and those who want to learn about feeding, circumcision and well-baby care. During the well-baby exam you may receive advice about your child’s safety, health, nutrition and development. These exams may also include immunizations and the following screenings:

• Hearing as a newborn and as your child’s health care provider advises
• Weight, length and head circumference
• Hemoglobin or hematocrit: once between 9 and 12 months
• Lead testing at ages 1 and 2 years unless lead exposure can be confidently excluded
• Age-appropriate developmental/behavioral assessments

Well-child exam: at age 30 months and then once a year for children ages 3 to 10. You may receive advice about your child’s safety, injury prevention, health, nutrition and development. Well-child exams may include immunizations and the following screenings:

• Blood pressure
• Vision screening
• Hearing
• Height, weight and Body Mass Index (BMI)^** percentile-for-age
• Age-appropriate developmental/behavior assessments

Well-child exam: once a year. Well-child exams may include immunizations, discussions on health and wellness issues (nutrition, physical activity, healthy weight, injury prevention, avoidance of tobacco, alcohol and drugs, sexual behavior, dental health, mental health and second-hand smoke) and the following screenings:

• Blood pressure
• Vision and hearing: at ages 12, 15 and 18 or as your child’s health care provider advises
• Height, weight and Body Mass Index (BMI)^**
• Chlamydia screening for sexually active females under 25

Adult Screenings

Well-person exam: at this exam you may receive immunizations, counseling on health and wellness issues (nutrition, including discussion of folic acid supplementation for women of child-bearing age, family planning, physical activity, healthy weight, injury prevention, misuse of tobacco, alcohol and drugs, sexual behavior, dental health, mental health and second-hand smoke) and the following screenings:

• Blood pressure
• Height, weight and Body Mass Index (BMI)^**
• Cholesterol: Every 5 years beginning at age 20

• Breast cancer: Self breast exam every month; clinical breast exam by your health care provider every 2 to 3 years
• Cervical cancer: Annually beginning within 3 years of sexual activity or age 21 (whichever comes first). Every 2 to 3 years for women ages 30 and older with 3 normal Pap tests in a row.
• Chlamydia: sexually active women 25 and under

• Cholesterol: To begin no later than age 35

Well-person exam: at this exam you may receive immunizations, counseling on health and wellness issues (nutrition, physical activity, healthy weight, injury prevention, misuse of tobacco, alcohol and drugs, sexual behavior, dental health, mental health and second-hand smoke) and the following screenings:

• Blood pressure
• Height, weight and Body Mass Index (BMI)^**
• Cholesterol: continued screening per health care provider
• Colorectal cancer: beginning at age 50, screening recommendations include 1 of these 6 testing options:
  • - Fecal Occult Blood Test (FOBT) each year
  • - Flexible sigmoidoscopy every 5 years
  • - Fecal Occult Blood Test (FOBT) each year, plus flexible sigmoidoscopy every 5 years
  • - Double-contrast barium enema every 5 years
  • - Colonoscopy every 10 years
  • - CT colonography may be an appropriate alternative to colonoscopy

• Breast cancer: Self breast exam every month; clinical breast exam by your health care provider and mammogram every year
• Cervical cancer: Every 2 to 3 years for women with 3 normal Pap tests in a row

• Prostate cancer: 50 and older discuss risk and benefits of prostate cancer screening with your health care provider

Well-person exam: at this exam you may receive immunizations, counseling on health and wellness issues (nutrition, physical activity, healthy weight, injury prevention, misuse of tobacco, alcohol and drugs, sexual behavior, dental health, mental health and second-hand smoke) and the following screenings:

• Blood pressure
• Height, weight and Body Mass Index (BMI)^**
• Cholesterol: Continued screening per health care provider
• - Fecal Occult Blood Test (FOBT) each year
• - Flexible sigmoidoscopy every 5 years
• - Fecal Occult Blood Test (FOBT) each year, plus flexible sigmoidoscopy every 5 years
• - Double-contrast barium enema every 5 years
• - Colonoscopy every 10 years
• - CT colonography may be an appropriate alternative to colonoscopy
• Hearing: as your health care provider recommends

• Breast cancer: self breast exam every month; clinical breast exam by your health care provider and mammogram every year
• Cervical cancer: every 2 to 3 years for women with 3 normal Pap tests in a row. Women 70 years of age or older who have had 3 or more normal Pap tests in a row and no abnormal Pap results in the last 10 years may choose to stop having cervical cancer screening.
• Osteoporosis: women at menopause should discuss the risks and benefits of screening with their health care provider. Bone density testing should begin no later than age 65. Earlier screening may be appropriate for some women.

• Abnormal aortic aneurysm: one time for ages 65 to 75 with any history of smoking
• Prostate cancer: discuss risks and benefits of prostate cancer screening with your health care provider

Pregnant women should visit their health care provider or OB/GYN in their first trimester for an initial visit and to establish a prenatal care schedule. During this visit your health care provider will check your health and the health of your baby.

Based on your medical history, your health care provider may recommend the following tests, screenings and immunizations:

Tests, education and screenings recommended for all pregnant women at their first prenatal visit:

• Hematocrit/Hemoglobin
• Syphillis
• HIV
• Rubella immunity to identify women needing rubella vaccine after giving birth
• Rh(D) blood type and antibody testing. If Rh(D) negative, repeat testing at 26 to 28 weeks.
• Hepatitis B
• Urinalysis as your health care provider advises
• Education regarding diet and activity during pregnancy
• Education and counseling regarding tobacco and other substance avoidance

• Special blood tests
• Ultrasound tests including special testing (used with blood tests during the first trimester for chromosomal abnormality risk) and routine two-dimensional tests for fetal assessment
• Amniocentesis
• Chorionic Villus Sampling

Two vaccines, Measles-Mumps-Rubella (MMR) and Varicella, should NOT be given during pregnancy.

Preventive Health Guidelines

The fact that a particular service or treatment is listed here is not a guarantee that it is covered under your benefit plan. Your benefit plan may, or may not, cover all preventive services described in this document. Please check with your benefit administrator for coverage details.

These guidelines are only a general guide intended for educational purposes.

Be sure to schedule regular exams with your doctor for you and your children using these recommendations as a guide. Factors that can place persons at risk for certain diseases are not discussed in these guidelines.

These preventive health guidelines are based on recommendations of independent national health care organizations, including:

• AAFP: American Academy of Family Physicians
• AAP: American Academy of Pediatrics
• ACIP: Advisory Committee on Immunization Practices
• ACOG: American College of Obstetrics and Gynecology
• ACS: American Cancer Society
• ATP III/NCEP: Adult Treatment Panel III / National Cholesterol Education Program
• CDC: Center for Disease Control and Prevention
• USPSTF: U.S. Preventive Services Task Force

Recommended Immunization Schedule^*

Vaccine

Birth

1-2 mo.

2 mo.

4 mo.

6 mo.

6-18 mo.

12-15 mo.

15-18 mo.

19-23 mo.

4-6 yrs.

11-12 yrs.

13-18 yrs.

19-49 yrs.

50-64 yrs.

65+ yrs.

Hepatitis B

1

Rotavirus

2-3 dose series2

Diphtheria-Tetanus-Pertussis (DTaP)

Tetanus-diphtheria-Pertussis (Td/Tdap)

Tdap

Td booster every 10 years

Haemophilus influenza type b (Hib)

3-4 dose series3

Pneumococcal (PCV)

Inactivated polio virus (IPV)

Influenza (flu)

Recommended annually from 6 months to 65 years of age

Measles, Mumps, Rubella (MMR)

Varicella (chicken pox)

Hepatitis A

2 dose series

Human Papillomavirus (HPV)

3 dose series

Meningococcal (MCV4)

Pneumococcal (PPV)

Recommended for smokers4

One lifetime dose

Zoster

One single dose for age ≥ 60

() Indicates when immunizations are recommended (1) Only if combination vaccine used after the birth dose (2) Rotavirus – 2 to 3 dose series depending on brand of vaccine used (3) Haemophilus influenza type b (Hib) - 3-4 dose series depending on the brand of vaccine used (4) Pneumococcal (PPSV) for smokers –Give 1 dose if unvaccinated or if previous vaccination history is unknown.

Tdap (adolescent) - If not previously vaccinated, those 13-18 years of age, discuss catch-up vaccination with your doctor.

Td (adults) - If not previously vaccinated with Tdap, substitute one single dose of Tdap for Td.

Influenza, new or updated vaccines - to www.flu.gov or www.cdc.gov for updated vaccine recommendations.

Measles, Mumps, Rubella (MMR) and Varicella - Those ages 19 and older who lack evidence of immunity (e.g., lack of documentation of vaccination or have no evidence of prior infection) should be vaccinated.

HPV - While vaccination with HPV is recommended for girls ages 11-12 years, it may be given as early as 9 years. For girls and women ages 13-26 years who have not been previously vaccinated, discuss catch-up vaccination with your doctor. HPV may be administered to males age 9-26 years to reduce their likelihood of acquiring genital warts.

Meningococcal vaccine (MCV) - If not previously vaccinated at 11-12 years of age, routine vaccination is recommended for 13-18 years of age and college freshmen living in dormitories.

Pneumococcal (PCV) – the recommended vaccine recently changed and children 14 - 59 months who completed the PCV vaccination series may need an additional vaccination with the new vaccine at the next medical visit. (Children 14 - 59 months who have completed the PCV vaccination series with 7-valent pneumococcal conjugate vaccine (PCV7) should receive a single supplemental dose of 13-valent pneumococcal conjugate vaccine (PCV13) at the next medical visit.)

For additional information on immunizations, please visit the Centers for Disease Control and Prevention (CDC) Website at www.cdc.gov.

* These Preventive Health Guidelines reflect recommendations for individuals of average risk. Individuals who are higher-risk, including but not limited to those in certain racial/ethnic groups or with personal/family medical history, should check with his/her health care provider for preventive health guidance.

** BMI: Height and weight are used to calculate BMI. BMI for children is gender and age specific and is used to assess underweight, overweight and risk for overweight. BMI for adults is used to assess whether a person is overweight and obese.

PHG information updated April, 2010.