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Preventive Health Guidelines

Make this year your best year for wellness. Your health plan may 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.

What is your plan for better health?

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.

Key resource

Preventive Health Care Guidelines

Well Woman Checkups

Child Lead Poisoning

Talk to your doctor if you have concerns about your health.

Well-baby and child screenings

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. 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, dental exams and care starting at age 1 year if needed, healthy eating and development. At these exams, your baby may get vaccines and these screenings or added screenings, such as tuberculin, urine testing and/or sickle cell anemia testing, if needed.

Well-child exam — ages 2½ 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, diet and physical activity, and development, as well as annual dental referrals starting at age 3 or earlier if needed. At these well-child exams, your child may get vaccines and these screenings or added screenings such as tuberculin and urine testing, if needed.

Well-child exam — ages 11 to 18 years

The doctor may talk to you about health and wellness issues. These include:

  • Diet and physical activity
  • Healthy weight
  • Dental health
  • Dentist referral each year
  • Mental health
  • Sexual behavior and screening for sexually transmitted infections
  • How to prevent injuries
  • Counseling to reduce your risk of getting skin cancer, special risks you might have for cancer (such as family history) and steps you can take to reduce those risks
  • Secondhand smoke
  • Avoiding tobacco, alcohol and drugs

At these exams, your child may get vaccines and these screenings or added screenings such as tuberculin and urine testing, if needed.

*This guide is for people enrolled in the Anthem plan. Talk to your doctor if you have concerns about your health.

**Height and weight is used to find BMI. BMI is used to see if a person has the right weight for height or is under or over weight for height.

Adult screenings – women

Well-person exam

The doctor may talk with you about health and wellness issues. These include:

  • Diet and physical activity
  • Family planning
  • Folic acid for women who are of the age to get pregnant
  • Sexual behavior and screening for sexually transmitted infections
  • Screening for HIV
  • Screening for hepatitis B (HBV) if high risk
  • Intimate partner violence
  • How to prevent injuries
  • Counseling to reduce your risk of getting skin cancer, special risks you might have for cancer (such as family history) and steps you can take to reduce those risks
  • Misuse of drugs and alcohol
  • Secondhand smoke
  • How to stop using tobacco
  • Dental health
  • Mental health, including screening for depression

At this visit, you may get vaccines and these screenings:

*This guide is for people enrolled in the Anthem plan. Some people may be at higher risk for health issues due to their family history, race, ethnicity or other reasons. Talk to your doctor if you have concerns about your health.

** Women should talk to their health care provider and choose the best age to begin screening and the potential to screen every 2 years at an older age.

Pregnant women*

Pregnant women should see their doctor or OB-GYN in their first three months of pregnancy 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:

  • Depression – screening during or after pregnancy
  • Diabetes – during pregnancy
  • Hematocrit/hemoglobin (blood count)
  • Hepatitis B
  • HIV
  • Rh(D) blood type and antibody testing – if Rh(D) negative, repeat test at 26 to 28 weeks
  • Rubella immunity – to find out which women need the rubella vaccine after giving birth
  • 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 also may 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

Medications:

If you are high risk for a condition called preeclampsia, your doctor may recommend the use of low-dose aspirin as a preventive medication.

Vaccines:

If you are pregnant in flu season (October to March), your doctor may want you to have the inactivated flu vaccine. Pregnant adolescents and adults should be vaccinated with Tdap vaccine with each pregnancy.

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 enrolled in the Anthem plan. Some people may be at higher risk for health issues due to their family history, race, ethnicity or other reasons. Talk to your doctor if you have concerns about your health.

Adult screenings – men

Well-person exam

The doctor may talk with you about health and wellness issues. These include:

  • Diet and physical activity
  • Family planning
  • How to prevent injuries
  • Misuse of drugs and alcohol
  • How to stop using tobacco
  • Secondhand smoke
  • Sexual behavior and screening for sexually transmitted infections
  • Screening for HIV
  • Screening for Hepatitis B (HBV) if high risk
  • Counseling to reduce your risk of getting skin cancer; special risks you might have for cancer (such as family history) and steps you can take to reduce those risks
  • Dental health
  • Mental health, including screening for depression

At this visit, you may get vaccines and these screenings:

*This guide is for people enrolled in the Anthem plan. Some people may be at higher risk for health issues due to their family history, race, ethnicity or other reasons. Talk to your doctor if you have concerns about your health.

Suggested vaccine schedule*

For more information about vaccinations, visit www.cdc.gov/vaccines.

Your plan may not pay for all services and treatments in this guide. To learn more about what your plan pays for, see your Member Handbook or call the Member Services number on your ID card.

Go to member handbooks

Learn more about how it pays to be HIP and healthy