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Preventive health guidelines
Download these Preventive Health Guidelines as a PDF file (PDF, 694KB)
| Immunizations: For men and women ages 50 and older | |
| Flu, annual | Recommended |
| Hepatitis A | For individuals with risk factors; for individuals seeking protection3 |
| Hepatitis B | For individuals with risk factors; for individuals seeking protection4 |
| Pneumococcal (pneumonia) | Recommended for individuals 65 and older and individuals under 65 with risk factors7 |
| Td booster (tetanus, diphtheria) | Recommended once every 10 years15 |
| Varicella (chickenpox) | Recommended for adults without evidence of immunity; should receive 2 shots10 |
| Zoster (shingles) | Recommended for all adults 60 and older |
| Screenings: For men and women ages 50 and older | |
| AAA (abdominal aortic aneurysm) | For men ages 65-75 who have ever smoked, one-time screen for AAA by ultrasonography |
| Alcohol misuse | Behavior counseling |
| Aspirin | Visit to discuss potential benefit of use19,20 |
| Blood pressure, depression, height, weight, BMI, vision, and hearing | At well visit |
| Breast cancer | Recommend mammogram every 1-2 years for women ages 50-7421 |
| Breast cancer chemoprevention | Covered for women at high risk for breast cancer and low risk for adverse effects from chemoprevention |
| Cervical cancer | At least every 3 years if cervix present; after age 65, Pap tests can be discontinued if previous tests have been normal |
| Colorectal cancer | Recommended for adults 50-7522 |
| Diabetes | Recommend type 2 diabetes screening for individuals with sustained blood pressure greater than 135/80 mm Hg23 |
| Gonorrhea | Recommended for all sexually active women who are at increased risk for infection11 |
| HIV | For all adults at increased risk for HIV infection24 |
| HPV | Recommended for all sexually active women 65 and younger |
| Lipid disorder | Screening periodically |
| Obesity | Screening, counseling, an behavioral interventions |
| Osteoporosis | Recommend routine screening for women 65 and older; routine screening for women 60-64 if at increased risk13 |
| Prostate cancer | Prostate-specific antigen (PSA) test and digital rectal exam |
| Sexually transmitted infections | Behavioral counseling as needed27 |
| Syphilis | Recommended for individuals at increased risk for infection12 |
| Tobacco use and cessation | Screening for tobacco use and cessation intervention |
For heart health, adults should exercise regularly (at least 30 minutes a day on most
days) which can help reduce the risks of coronary heart disease, osteoporosis, obesity
and diabetes. Consult your physician before starting a new vigorous physical activity.
Topics you may want to discuss with your doctor
Nutrition
- Eat a healthy diet. Limit fat and calories. Eat fruits, vegetables, beans and whole grains every day.
- Optimal calcium intake is estimated to be 1,500 mg/day for postmenopausal women not on estrogen therapy.
- Sexually transmitted infection (STI)/HIV prevention,16 practice safer sex (use condoms) or abstinence.
- Avoid unintended pregnancy; use contraception.
- Stop smoking. Limit alcohol consumption. Avoid alcohol or drug use while driving.
- Floss and brush with fluoride toothpaste daily. Seek dental care regularly.
- Fall prevention.
- Possible risks and benefits of hormone replacement therapy (HRT) for post-menopausal women.
- Risks for and possible benefits of prostate cancer screening in men to determine what is best for you.
- Domestic violence and abuse.
- The dangers of drug interactions.
Download these Preventive Health Guidelines as a PDF file:
Preventive Health Guidelines - English (PDF, 694KB)
Notes
2. Recommended for all children from 6 months through 18 years of age and anyone 50 years of age or older. Anyone at risk of complications from influenza are more likely to require medical care, including pregnant women during flu season, individuals with long-term health problems or weakened immune system or muscle or nerve disorders, anyone 6 months through 18 years of age on long-term aspirin treatment, and residents of nursing homes and other chronic-care facilities. Healthcare providers, household contacts, and caregivers of children from birth to 5 years of age and people 50 and older are recommended for the flu vaccine.
3. Risk factors for hepatitis A include: persons with clotting factor disorders or chronic liver disease; men who have sex with men or users of illegal drugs; persons working with hepatitis A virus (HAV)-infected primates or with HAV in a research laboratory setting, and persons traveling to or working in countries that have high or intermediate endemicity of hepatitis A.
4. Risk factors for hepatitis B infection include injection drug users; people who have multiple sexual partners or sexual contact with people with HBV infection; men who have sex with men; hemodialysis patients, staff and residents in institutions for the developmentally disabled; inmates of long-term correctional facilities; and certain international travelers.
5. Measles component: Adults born before 1957 can be considered immune to measles. Adults born on or after 1957 should receive one or more doses of MMR , depending upon their immune status. Also, a second dose of MMR may be necessary if exposed, traveling internationally, and other factors. Rubella component: Women with unreliable vaccination history should check with their provider. Check with your doctor for details regarding pregnancy.
7. One dose for adults at risk, including those with chronic lung diseases (including asthma and COPD); cardiovascular diseases, diabetes mellitus, chronic liver disease, chronic renal failure, sickle cell disease, and immunocompromising conditions. Vaccination is also recommended in adults who smoke cigarettes and residents of nursing homes and long term care facilities. Vaccination is not recommended in Alaskan Native or Native American persons unless they have another risk factor present. A second Pneumococcal dose may be necessary for people age 65 and older who received the vaccine more than 5 years previously and were younger than 65 at the time of the primary vaccination. A one-time revaccination is recommended after 5 years for people with certain medical conditions, including immunosuppressive conditions and people who have undergone chemotherapy.
8. Individuals at risk for meningococcal disease include international travelers, college-bound students, or anyone with a damaged or removed spleen or with terminal complement component deficiency. These individuals should discuss the risks and benefits of vaccination with their doctor.
9. Lipid disorders risk factors for men aged 20-35 or women 20 years and older include diabetes, previous personal history of congestive heart disease or non-coronary atherosclerosis, family history of cardiovascular disease before age 50 in male relatives and age 60 in female relatives, tobacco use, and obesity (BMI ≥ 30).
10. Individuals at risk for varicella infection include those who have close contact with persons at high risk for severe disease (healthcare workers and family contacts of immunocompromised persons) or are at high risk for exposure or transmission (e.g., teachers of young children; child care employees; residents and staff members of institutional settings, including correctional institutions; college students; military personnel; adolescents and adults living in households with children; nonpregnant women of childbearing age; and international travelers).
11. Risk factors for chlamydia and gonorrhea infection include history of chlamydial or other sexually transmitted infections, new or multiple sexual partners, inconsistent condom use, commercial sex work and drug use.
12. Risk factors for syphilis infection include all adolescents and adults who receive health care in a high-prevalence or high-risk clinical setting, men who have had sex with men, commercial sex workers, and those in adult correctional facilities. Individuals being treated for sexually transmitted diseases may be more likely than others to engage in high-risk behavior.
13. Increased risks for osteoporosis include women aged 60 to 64 with all of the following risks for osteoporotic fractures: lower body weight (weight < 70 kg) and no current use of estrogen therapy.
14. People with increased risk for coronary heart disease who may benefit from aspirin therapy are men over age 40, postmenopausal women, and younger people with hypertension, diabetes or who smoke.
15. People in contact with infants under 12 months of age and healthcare personnel can be given the Td vaccine as soon as feasible. It is recommended that Tdap should replace a single dose of Td for adults aged < 65 years if they have not previously received a dose of Tdap.
16. Sexually transmitted infections, also known as sexually transmitted diseases, include chlamydia, gonorrhea, herpes, HIV, HPV, syphilis and others. See infection-specific notes for information on risk factors for sexually transmitted infections.
19. Potential benefit of aspirin use in men 45 to 79 due to a reduction in myocardial infarctions outweighs the potential harm due to an increase in gastrointestinal hemorrhage.
20. Potential benefit of aspirin use in women 55 to 79 due to a reduction in ischemic strokes outweighs the potential harm due to an increase in gastrointestinal hemorrhage.
21. For breast cancer screening, BRCA mutation referral for genetic risk assessment and evaluation for breast and ovarian susceptibility is recommended for women with family history associated with an increased risk for deleterious mutations in BRCA1 or BRCA2 genes.
22. Colorectal cancer screenings include fecal occult blood annually, sigmoidoscopy every five years, and colonoscopy every 10 years. Beginning age and screening interval can be reduced for patients at increased risk.
23. Diabetes screening should be performed for patients with blood pressure 135/80 or lower if knowledge of diabetes status would help inform decisions about coronary heart disease prevention strategies.
24. Individuals at risk for HIV infection include all adolescents and adults who receive health care in high-prevalence or high-risk clinical setting, men who have had sex with men after 1975, individuals having unprotected sex with multiple partners, past or present injecting drug users, commercial sex workers, individuals whose past or present sex partners were HIV infected, bisexual, or injection drug users, individuals being treated for sexually transmitted diseases, individuals with a history of blood transfusion between 1978 and 1985, and individuals who requested an HIV test despite reporting no individual risk factors.
25. Fluoride oral supplementation should be discussed at preventive care visit if primary water source is deficient in fluoride.
26. Increased risk factors for prostate cancer include African-American men and men with family history of prostate cancer.
27. Behavioral counseling to prevent sexually transmitted infections is for sexually active adolescents and adults who meet the following criteria: current sexually transmitted infections, sexually transmitted infections within the past year, multiple current sexual partners, and in non-monogamous relationships if they reside in a community with a high rate of sexually transmitted infections.
28. Intensive behavioral counseling to promote healthy diet is recommended for all adults who have hyperlipidemia or have any known risk factors for cardiovascular and diet-related chronic disease.
Notes
These are Blue Shield of California's Preventive Health Guidelines which are based on nationally recognized guidelines. Members must refer to their Evidence of Coverage or Certificate of Insurance or Policy for plan/policy coverage of preventive health benefits.
3. Risk factors for hepatitis A include: persons with clotting factor disorders or chronic liver disease; men who have sex with men or users of illegal drugs; persons working with hepatitis A virus (HAV)-infected primates or with HAV in a research laboratory setting, and persons traveling to or working in countries that have high or intermediate endemicity of hepatitis A.
4. Risk factors for hepatitis B infection include injection drug users; people who have multiple sexual partners or sexual contact with people with HBV infection; men who have sex with men; hemodialysis patients, staff and residents in institutions for the developmentally disabled; inmates of long-term correctional facilities; and certain international travelers.
5. Measles component: Adults born before 1957 can be considered immune to measles. Adults born on or after 1957 should receive one or more doses of MMR , depending upon their immune status. Also, a second dose of MMR may be necessary if exposed, traveling internationally, and other factors. Rubella component: Women with unreliable vaccination history should check with their provider. Check with your doctor for details regarding pregnancy.
7. One dose for adults at risk, including those with chronic lung diseases (including asthma and COPD); cardiovascular diseases, diabetes mellitus, chronic liver disease, chronic renal failure, sickle cell disease, and immunocompromising conditions. Vaccination is also recommended in adults who smoke cigarettes and residents of nursing homes and long term care facilities. Vaccination is not recommended in Alaskan Native or Native American persons unless they have another risk factor present. A second Pneumococcal dose may be necessary for people age 65 and older who received the vaccine more than 5 years previously and were younger than 65 at the time of the primary vaccination. A one-time revaccination is recommended after 5 years for people with certain medical conditions, including immunosuppressive conditions and people who have undergone chemotherapy.
8. Individuals at risk for meningococcal disease include international travelers, college-bound students, or anyone with a damaged or removed spleen or with terminal complement component deficiency. These individuals should discuss the risks and benefits of vaccination with their doctor.
9. Lipid disorders risk factors for men aged 20-35 or women 20 years and older include diabetes, previous personal history of congestive heart disease or non-coronary atherosclerosis, family history of cardiovascular disease before age 50 in male relatives and age 60 in female relatives, tobacco use, and obesity (BMI ≥ 30).
10. Individuals at risk for varicella infection include those who have close contact with persons at high risk for severe disease (healthcare workers and family contacts of immunocompromised persons) or are at high risk for exposure or transmission (e.g., teachers of young children; child care employees; residents and staff members of institutional settings, including correctional institutions; college students; military personnel; adolescents and adults living in households with children; nonpregnant women of childbearing age; and international travelers).
11. Risk factors for chlamydia and gonorrhea infection include history of chlamydial or other sexually transmitted infections, new or multiple sexual partners, inconsistent condom use, commercial sex work and drug use.
12. Risk factors for syphilis infection include all adolescents and adults who receive health care in a high-prevalence or high-risk clinical setting, men who have had sex with men, commercial sex workers, and those in adult correctional facilities. Individuals being treated for sexually transmitted diseases may be more likely than others to engage in high-risk behavior.
13. Increased risks for osteoporosis include women aged 60 to 64 with all of the following risks for osteoporotic fractures: lower body weight (weight < 70 kg) and no current use of estrogen therapy.
14. People with increased risk for coronary heart disease who may benefit from aspirin therapy are men over age 40, postmenopausal women, and younger people with hypertension, diabetes or who smoke.
15. People in contact with infants under 12 months of age and healthcare personnel can be given the Td vaccine as soon as feasible. It is recommended that Tdap should replace a single dose of Td for adults aged < 65 years if they have not previously received a dose of Tdap.
16. Sexually transmitted infections, also known as sexually transmitted diseases, include chlamydia, gonorrhea, herpes, HIV, HPV, syphilis and others. See infection-specific notes for information on risk factors for sexually transmitted infections.
19. Potential benefit of aspirin use in men 45 to 79 due to a reduction in myocardial infarctions outweighs the potential harm due to an increase in gastrointestinal hemorrhage.
20. Potential benefit of aspirin use in women 55 to 79 due to a reduction in ischemic strokes outweighs the potential harm due to an increase in gastrointestinal hemorrhage.
21. For breast cancer screening, BRCA mutation referral for genetic risk assessment and evaluation for breast and ovarian susceptibility is recommended for women with family history associated with an increased risk for deleterious mutations in BRCA1 or BRCA2 genes.
22. Colorectal cancer screenings include fecal occult blood annually, sigmoidoscopy every five years, and colonoscopy every 10 years. Beginning age and screening interval can be reduced for patients at increased risk.
23. Diabetes screening should be performed for patients with blood pressure 135/80 or lower if knowledge of diabetes status would help inform decisions about coronary heart disease prevention strategies.
24. Individuals at risk for HIV infection include all adolescents and adults who receive health care in high-prevalence or high-risk clinical setting, men who have had sex with men after 1975, individuals having unprotected sex with multiple partners, past or present injecting drug users, commercial sex workers, individuals whose past or present sex partners were HIV infected, bisexual, or injection drug users, individuals being treated for sexually transmitted diseases, individuals with a history of blood transfusion between 1978 and 1985, and individuals who requested an HIV test despite reporting no individual risk factors.
25. Fluoride oral supplementation should be discussed at preventive care visit if primary water source is deficient in fluoride.
26. Increased risk factors for prostate cancer include African-American men and men with family history of prostate cancer.
27. Behavioral counseling to prevent sexually transmitted infections is for sexually active adolescents and adults who meet the following criteria: current sexually transmitted infections, sexually transmitted infections within the past year, multiple current sexual partners, and in non-monogamous relationships if they reside in a community with a high rate of sexually transmitted infections.
28. Intensive behavioral counseling to promote healthy diet is recommended for all adults who have hyperlipidemia or have any known risk factors for cardiovascular and diet-related chronic disease.
Notes
These are Blue Shield of California's Preventive Health Guidelines which are based on nationally recognized guidelines. Members must refer to their Evidence of Coverage or Certificate of Insurance or Policy for plan/policy coverage of preventive health benefits.