Preventive Guidelines

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 - Birth to 2 Years*

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:


Well Child - Ages 3 to 10*

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:


Well Child - Ages 11 to 18*

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:


Adult Screenings

Adult - Ages 19 to 39*

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:

Women Men


Adult - Ages 40 to 64*

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:

Women Men


Adult - Ages 65 and Older*

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:

Women Men


Pregnant Women*

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:

Other Tests and Screenings
Several tests either alone or in combination can be used to assess the fetus for abnormalities. These various tests are done at different times during the pregnancy, and the optimal test depends upon a number of factors including your age, medical history and family history. Discuss with your health care provider what information these tests provide, the risks of different tests and which, if any, may be best for you, including: Immunizations
It is recommended that women who will be pregnant during flu season (October to March) have the inactivated influenza vaccine. Also, the Tetanus-diphtheria-Pertussis (Tdap) vaccine is advised if it was not previously received. While other vaccines may be appropriate in special circumstances, it is generally recommended to get needed vaccines before becoming pregnant. Women should always check with their health care provider to discuss special circumstances and needs.

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:


Recommended Immunization Schedule*


Vaccine Birth 1-2
mo.
2
mo.
4
mo.
6
mo.
6-18
mo.
12-15
mo.
15-18
mo.
24
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)                              
Pneumococcal (PCV)                              
Inactivated polio virus (IPV)                              
Influenza (flu)         Recommended annually from 6 months to 18 years of age   Recommended annually from 50-65+ 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 smokers3 
 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) Pneumococcal (PPSV) for smokers –Give 1 dose if unvaccinated or if previous vaccination history is unknown

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.

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.

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.

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.

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

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.

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