Wellness exams
SERVICE
GROUP AGE, FREQUENCY
Well-baby/well-child/well-person exams, including annual well-woman exam (includes height, weight, head circumference, BMI, blood pressure, history, anticipatory guidance, education regarding risk reduction, psychosocial/behavioral assessment)
• Birth, 1, 2, 4, 6, 9, 12, 15, 18, 24 and 30 months • Additional visit at 2–4 days for infants discharged less than 48 hours after delivery • Ages 3 to 21, once a year • Ages 22 and older, periodic visits as doctor advises
Routine immunizations covered under preventive care
SERVICE
SERVICE
Diphtheria, Tetanus Toxoids and Acellular Pertussis (DTaP, Tdap, Td)
Meningococcal (meningitis) Pneumococcal (pneumonia)
Haemophilus influenzae type b conjugate (Hib)
Hepatitis A (Hep A) Hepatitis B (Hep B)
Poliovirus (IPV) Rotavirus (RV)
Varicella (chickenpox)
Human papillomavirus (HPV) (age criteria may apply for some vaccine brands)
Influenza vaccine
Zoster (shingles)
Measles, mumps and rubella (MMR)
You may view the immunization schedules on the CDC website: cdc.gov/vaccines/schedules/ .
Health screenings and interventions
SERVICE
GROUP AGE, FREQUENCY
Abnormal blood glucose and type 2 diabetes screening/counseling
Adults ages 40–70 who are overweight or obese; women with a history of gestational diabetes mellitus
Alcohol misuse/substance abuse screening
All adults; adolescents age 11–21
Aspirin to prevent cardiovascular disease and colorectal cancer, or to reduce risk for preeclampsia 1
Adults ages 50–59 with risk factors; Pregnant women at risk for preeclampsia
Autism screening
18, 24 months
Bacteriuria screening
Pregnant women
Bilirubin screening (effective on or after 1/1/18 as plans renew)
Newborns before discharge from hospital
Breast cancer screening (mammogram)
Women ages 40 and older, every 1–2 years
Breast-feeding support/counseling, supplies 2
During pregnancy and after birth
Cervical cancer screening (Pap test) HPV DNA test alone or with Pap test
Women ages 21–65, every 3 years Women ages 30–65, every 5 years
Chlamydia screening
Sexually active women ages 24 and under and older women at risk
Cholesterol/lipid disorders screening 1
• Screening of children and adolescents ages 9–11 years and 17–21 years; children and adolescents with risk factors, ages 2–8 and 12–16 years • All adults ages 40–75 The following tests will be covered for a colorectal cancer screening, ages 50 and older: • Fecal occult blood test (FOBT) or fecal immunochemical test (FIT) annually • Flexible sigmoidoscopy every 5 years • Double-contrast barium enema (DCBE) every 5 years • Colonoscopy every 10 years • Computed tomographic colonography (CTC)/virtual colonoscopy every 5 years - Requires prior authorization • Stool-based deoxyribonucleic acid (DNA) test (i.e., Cologuard) every 3 years
Colon cancer screening 1
Congenital hypothyroidism screening
Newborns
Critical congenital heart disease screening
Newborns before discharge from hospital
= Men
= Women
= Children/adolescents
7
Made with FlippingBook Online newsletter maker