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Preventive Health Guidelines

As of May 2014

 

What is your plan for better health?

Make this year your best year for wellness. Your health plan may help pay for tests to find disease early and routine wellness exams to help you and your family stay well. Talk with your doctor (health care provider) about the care that is right for you.
 
Your plan may not pay for all services and treatments in this guide. To learn more about what your plan pays for, see your certificate of coverage or call the customer care number on your ID card.
 
You also can check anthem.com to learn about health topics from child care to zinc.
 
This guide is just for your learning; it is not meant to take the place of medical care.
 
Use this guide to know when to set up visits with your doctor for you and your children. Ask your doctor which exams, tests and vaccines are right for you, when you should get them and how often.
 
How you get certain diseases is not talked about in this guide.
 
Please see your plan handbook to check on your plan benefits.
 


Well-baby exam — birth to 2 years*:

Infants who leave the hospital less than two days (48 hours) after birth need to be seen by a doctor within two to four days after being born. Also, you might want to talk to a doctor before your baby is born. You might talk to the doctor if you are a first-time parent, are having a high-risk pregnancy, or want to learn about feeding, circumcision or well-baby care. At the well-baby exam you may get advice on your child's safety, health, healthy eating and development. At these exams, your baby may get vaccines and these screenings:
 
 Age (in months)
Screeningsbirth1246912151824
Weight, length and head circumference (the length around the head)at each visit
Newborn metabolic, sickle cell and thyroid screeningbetween birth and two months       
Development and behaviorat each visit
Hearingas a newborn and when your doctor suggests
Oral/dental health    at 6at 9at 12 at 18at 24
Hemoglobin or hematocrit (blood count)     Once
between 9 and 12
   
Lead testing unless you are sure the child has not been around lead      at 12  at 24
Autism        at 18at 24
 
 Age (in months)

Suggested Vaccines*
For additional information regarding vaccinations refer to http://www.cdc.gov/vaccines

birth1-22466-1812-1515-1819-23
Hepatitis BCheckedChecked   Checked   
Rotavirus (RV)  Checked 2-dose or 3-dose series    
Diphtheria, tetanus, pertussis (DTaP)  CheckedCheckedChecked  Checked 
Haemophilus influenza type b (Hib)  Checked 3- or 4-dose series - 1st dose at 2 months - last dose at 12-15 months 
Pneumococcal conjugate (PCV)  CheckedCheckedChecked Checked  
Inactivated polio virus (IPV)  CheckedChecked Checked   
Influenza (Flu)    Checked suggested each year from 6 months to 65+years of age
Measles, mumps, rubella (MMR)      Checked  
Varicella (chicken pox)      Checked  
Hepatitis A      Checked 2-dose series
 
Checked Shows when vaccines are suggested
 
Hepatitis B -You may get an extra dose (4-dose series) at 4 months if the combination vaccine is used after the birth dose.
Rotavirus (RV) - Get 2-dose or 3-dose series (depends on brand of vaccine used).
Haemophilus influenza type b (Hib) - Get 3-dose or 4-dose series (depends on brand of vaccine used).
Pneumococcal conjugate (PCV) - Children aged 14 months through 59 months who have received an age-appropriate series of 7-valent PCV (PCV-7), administer a single supplemental dose of 13-valent PCV (PCV-13)
Influenza (Flu) - Refer to flu.gov or cdc.gov to learn more about this vaccine.(Note: children 6 months to 8 years of age having the vaccine for the first time should have two doses separated by 4 weeks)
Measles, mumps, rubella (MMR) and varicella (chicken pox) - All adults born after 1957 should have documentation of 1 or more doses of MMR vaccine unless they have a medical contraindication to the vaccine, or laboratory evidence of immunity to each of the three diseases.
 
* This guide is for people with average risk. Some people may be at higher risk for health issues due to their family health history, their race or ethnicity, or other reasons. Talk to your doctor if you have concerns about your health.
 
 
Sources
 

Well-child exam — ages 2 ½ to 10 years*:

You may get advice about how to keep your child safe, how to prevent injuries, counseling to reduce the risks of getting skin cancer, good health, healthy eating and development. At ages 3 and 6, a referral to a dentist may be suggested. At these well-child exams, your child may get vaccines and these screenings:
 
 Age (in years)
Screenings2 1/2345678910
Height, weight, body mass index (BMI)**each year
Development and behaviorat each visit
Visioneach year
Hearingeach year
Oral/dental healthat 2 1/2        
Blood pressure each year starting at 3 years
 
**Height and weight is used to find BMI. BMI is used to see if a person has an appropriate weight for height, or is under or over weight for height.
 
 Age (in years)

Suggested Vaccines*
For additional information regarding vaccinations refer to http://www.cdc.gov/vaccines

2 1/234567-10
Diphtheria, tetanus, pertussis (DTaP)  Checked once between 4 and 6 
Inactivated polio virus (IPV)  Checked once between 4 and 6 
Influenza (Flu)Checked each year
Measles, mumps, rubella (MMR)  Checked once between 4 and 6 
Varicella (chicken pox)  Checked once between 4 and 6 
Checked Shows when vaccines are suggested
 

Well-child exam — ages 11 to 18 years*:

The doctor may talk to you about health and wellness issues. These include healthy eating, exercise, healthy weight, how to prevent injuries, counseling to reduce the risks of getting skin cancer, secondhand smoke, avoiding tobacco, alcohol and drugs, sexual behavior, dental health and mental health. At this visit, you may get vaccines and these screenings
 
 Age (in years)
Screenings1112131415161718
Height, weight, body mass index (BMI)**each year
Development and behavioreach year
Blood pressureeach year
Visioneach year
Hearingeach year
Chlamydiafor sexually active women aged 25 and younger
 
**Height and weight is used to find BMI. BMI is used to see if a person has an appropriate weight for height, or is under or over weight for height.
 
 Age (in years)

Suggested Vaccines*
For additional information regarding vaccinations refer to http://www.cdc.gov/vaccines

11-1213-18
Tetanus, diphtheria, pertussis (Td/Tdap)Checked 
Influenza (Flu)Checked each year
Human papillomavirus (HPV)Checked 3-dose (series) 
MeningococcalCheckedChecked at 16 years of age
Checked Shows when vaccines are suggested
 
Tdap (teens) - If you are 13 to 18 years of age and have not had this vaccine before, talk to your doctor about a catch-up vaccine.
Influenza (Flu) - Refer to flu.gov or cdc.gov to learn more about this vaccine.(Note: Children 6 months to 8 years of age having the vaccine for the first time should have two doses.)
Human papillomavirus (HPV) - This vaccine is for girls (HPV2 or HPV4) and boys (HPV4) 11 to 12 years of age, but it may be given as early as 9 years of age. This vaccine can be given up to age 26.Administer second dose 1-2 months after first dose; administer third dose 24 weeks after the first dose and 16 weeks after the second dose.
Meningococcal - Two doses of this vaccine are given. The first dose at 11 or 12 years of age and the next dose at 16.
 
* This guide is for people with average risk. Some people may be at higher risk for health issues due to their family health history, their race or ethnicity, or other reasons. Talk to your doctor if you have concerns about your health.
 
    
Sources   
    

Well-person exam —

The doctor may talk with you about health and wellness issues. These include healthy eating, exercise, family planning for ages 19-39, how to prevent injuries, misuse of drugs and alcohol, how to stop using tobacco, secondhand smoke, sexual behavior and HIV screening, counseling to reduce the risks of getting skin cancer, special risks you might have for cancer (such as family history) and steps you can take to manage any such risks, dental health and mental health. At this visit, you may get vaccines and these screenings:
 
 Age (in years)
Screenings1920253035404550556065 and older
Height, Weighteach year or as your doctor suggests
BMIeach year or as your doctor suggests
Blood pressureeach year or as your doctor suggests
Cholesterol every 5 years starting at age 20 with more screenings as your doctor suggests
Colorectal cancer       

at age 50, your doctor may suggest one of these test options:

  1. Fecal occult blood test (FOBT) each year
  2. Flexible sigmoidoscopy every 5 years
  3. Both #1 and #2
  4. Double-contrast barium enema every 5 years
  5. Colonoscopy every 10 years
  6. CT colonography may take the place of a colonoscopy in some cases
Prostate cancer       if you are 50 or older, discuss with your doctor the risks and benefits of the prostate cancer tests
Abdominal aortic aneurysm          one time for ages 65-75 for those who have ever smoked
Hepatitis C       screen once if born between 1945-1965
 
 Age (in years)

Suggested Vaccines*
For additional information regarding vaccinations refer to http://www.cdc.gov/vaccines

19-6060-6465+
Tetanus, diphtheria, pertussis (Td/Tdap)Checked Td booster every 10 years
Influenza (Flu)Checked suggested each year from 6 months to 65+ years of age
Pneumococcal polysaccharide (PPSV 23)Checked suggested for smokers and asthmaticsChecked
Zoster 1 single dose for ages 60+
Checked Shows when vaccines are suggested
 
Tdap (adults) - If you are 19 years of age or older and have not gotten a dose of Tdap before, you should get a single dose.
Influenza (Flu) - Refer to flu.gov or cdc.gov to learn more about this vaccine.(Note: Children 6 months to 8 years of age having the vaccine for the first time should have two doses.)
Pneumococcal polysaccharide (PPSV 23) - Smokers and asthmatics should get 1 dose if they’ve never gotten the vaccine or don’t know their vaccine history. Anyone who got the vaccine before age 65 should get another dose after 65 (just wait at least 5 years in between doses - Administer PCV-13 first to those who are uncertain of their vaccination history.).
 
 

Well-person exam:

The doctor may talk with you about health and wellness issues. These include healthy eating, exercise, family planning for ages 19-39 and folic acid for women who are of the age to get pregnant, sexual behavior and screening for sexually transmitted diseases including HIV, intimate partner violence, how to prevent injuries, counseling to reduce the risks of getting skin cancer, special risks you might have for cancer (such as family history) and steps you can take to manage any such risks, misuse of drugs and alcohol, how to stop using tobacco, secondhand smoke, dental health and mental health. At this visit, you may get vaccines and these screenings:
 
 Age (in years)
Screenings19-2121-293035404550556065 and older
Height, weighteach year or as your doctor suggests
BMIeach year or as your doctor suggests
Blood pressureeach year or as your doctor suggests
Breast cancer: doctor examevery 1 to 3 yearseach year from age 40 to 65+
Breast cancer: mammogram    each year from age 40 to 65+
Cervical cancer: ages 21-29 every three years        
Cervical cancer: ages 30-65  Should have a Pap test plus an HPV test (called "co-testing") every 5 years. This is the preferred approach, but it is also OK to have a Pap test alone every 3 years
Cervical cancer: ages 65+         Stop screening at age 65 if last three Pap tests or last two Co-tests (Pap plus HPV) within the previous 10 years were normal. If there is a history of an abnormal Pap test within the past 20 years, discuss continued screening with your doctor.
Colorectal cancer      

at age 50, your doctor may suggest one of these test options:

  1. Fecal occult blood test (FOBT) each year
  2. Flexible sigmoidoscopy every 5 years
  3. Both #1 and #2
  4. Double-contrast barium enema every 5 years
  5. Colonoscopy every 10 years
  6. CT colonography may take the place of a colonoscopy in some cases
Chlamydiasexually active women ages 25 and younger        
Cholesterolevery 5 years starting at age 20 with more screenings as your doctor suggests
Osteoporosis      the test to check how dense your bones are should start no later than age 65; women at menopause should talk to their doctor about osteoporosis and have the test when at risk
Hepatitis C      screen once if born between 1945-1965
 
 Age (in years)

Suggested Vaccines*
For additional information regarding vaccinations refer to http://www.cdc.gov/vaccines

19-6060-6465+
Tetanus, diphtheria, pertussis (Td/Tdap)Checked Td booster every 10 years
Influenza (Flu)Checked suggested each year from 6 months to 65+ years of age
Pneumococcal polysaccharide (PPSV 23)Checked suggested for smokers and asthmaticsChecked
Zoster 1 single dose for ages 60+
 
Checked Shows when vaccines are suggested
 
Tdap (adults)- If you are 19 years of age or older and have not gotten a dose of Tdap before, you should get a single dose.
Influenza (Flu) - Refer to flu.gov or cdc.gov to learn more about this vaccine.(Note: Children 6 months to 8 years of age having the vaccine for the first time should have two doses.)
Pneumococcal polysaccharide (PPSV 23) - Smokers and asthmatics should get 1 dose if they’ve never gotten the vaccine or don’t know their vaccine history. Anyone who got the vaccine before age 65 should get another dose after 65 (just wait at least 5 years in between doses- Administer PCV-13 first to those who are uncertain of their vaccination history.).
 
Pregnant women should see their doctor or OB/GYN in their first three months for a first visit and to set up a prenatal care plan. At this visit your doctor will check your health and the health of your baby. Based on your past health, your doctor may want you to have these tests, screenings or vaccines:
  • Diabetes during pregnancy
  • Hematocrit/hemoglobin (blood count)
  • Hepatitis B 
  • HIV
  • Rubella immunity - to find out which women need the rubella vaccine after giving birth
  • Rh(D) blood type and antibody testing - if Rh(D) negative, repeat test at 26 to 28 weeks
  • Syphilis
  • Urinalysis - when your doctor wants it
The doctor may talk to you about what to eat and how to be active when pregnant as well as staying away from tobacco, drugs, alcohol and other substances. You may also discuss breastfeeding support, supplies and counseling
 
Other tests and screenings:
Some tests given alone or with other tests can be used to check the baby for health concerns. These tests are done at certain times while you are pregnant. The best test to use and the best time to do it depends on many things. These include your age as well as your medical and family history. Talk to your doctor about what these tests can tell you about your baby, the risks of the tests and which tests may be best for you.
 
  • Amniocentesis
  • Chorionic villus sampling
  • Special blood tests
  • Ultrasound tests including special tests (used with blood tests during the first three months for chromosomal abnormality risk) and routine two-dimensional tests to check on the baby
 
Vaccines:
If you are pregnant in flu season (October to March) your doctor may want you to have the inactivated flu vaccine. You may need the tetanus, diphtheria, pertussis (Tdap) vaccine if you have not had it before. While other vaccines may be given in special cases, it is best to get the vaccines you need before you get pregnant. Women should always check with their doctor about their own needs.
 
You should NOT get these vaccines while you are pregnant:
  • Measles, mumps, rubella (MMR)
  • Varicella
 
* This guide is for people with average risk. Some people may be at higher risk for health issues due to their family health history, their race or ethnicity, or other reasons. Talk to your doctor if you have concerns about your health.
 
 

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