By visiting each year with your Primary Care Network Provider to know your health numbers, you can establish
goals to manage
your health risks, feel better and live a healthier life. Your annual wellness visit can help you identify
potential health
issues before they become serious problems.
Taking ownership of your health and living a healthy lifestyle today will allow you to be healthier in the
future. You and your
Primary Care Network Provider will not only be managing your health, but also your future healthcare costs.
There are some important numbers that you need to know to understand your risks for heart disease, stroke,
diabetes, cancer and
other diseases. These important numbers also known as biometrics, include your blood pressure, cholesterol,
blood sugar (glucose),
height and weight. Talk with your Primary Care Network Provider about these numbers – and make sure you know
them at the end of your
wellness visit.
Blood Pressure
XBlood pressure is the force of blood against the inside walls of your
arteries. It is
recorded by systolic pressure, which is the pressure when blood is pumped out of the heart and into your
arteries, and
diastolic pressure, which is the pressure when your heart is resting. Normal blood pressure is
classified with a number of
less than 120 (systolic) over 80 (diastolic). High blood pressure, or hypertension, can increase your
risk of heart disease,
heart attack, and stroke. Like many health problems, blood pressure can often be managed through
lifestyle changes such as
eating healthy, exercising, and being tobacco-free.
Cholesterol
XCholesterol is a naturally occurring substance in the blood, but too
much can increase your risk for heart disease. Your doctor will check different cholesterol levels in
your blood to evaluate your risks. These types of cholesterol include "good" cholesterol (HDL), "bad"
cholesterol (LDL) and triglycerides. You can have an impact on improving the "good" cholesterol and
lowering the "bad" cholesterol with lifestyle changes.
Talk with your Primary Care
Network Provider about how to make these changes. Many times, it is possible to maintain a healthy
cholesterol level through diet and exercise. If your provider does recommend a prescription drug, be
sure to ask for a generic or lower-cost alternative."
Blood Sugar (A1c)
XHigh Blood sugar can lead to diabetes. Diabetes is a condition that results in the inability of the body to process carbohydrates and sugar. Diabetes is one of the fastest growing health problems and one of the leading causes of death in the United States. An A1c test result reflects your average blood sugar level for the past two to three months. The higher the levels, the greater your risk of developing diabetes.
Type 2 diabetes can be managed, or even prevented, by living a healthy lifestyle that includes a healthy diet and exercise.
BMI (Healthy Weight)
XBeing overweight can elevate your blood pressure, lead to Type 2
diabetes, and increase your risk for heart
disease, cancer, arthritis and depression. Body Mass Index (BMI) is the most common measure for defining
if you are overweight or obese.
If you are overweight or obese, talk with your provider about healthy ways to lose weight through
changing your diet so you eat less
(and eat healthy) and through exercise (by becoming more physically active).
How Healthy Are You?
Recommended Screenings:
Select the appropriate gender and age range to view services and screenings that are recommended for you at
your wellness visit. Make sure
to speak to your Primary Care Network Provider about these services at your wellness visit. Also check out
the list of questions to ask your
doctor below and think about any additional questions you may want to ask your Primary Care Network Provider
at your visit.
Gender
Gender
Age Range
Preventive Medicine
Evaluation or Re-evaluation
Preventive Medicine
Evaluation or Re-evaluation
Hemoglobin, Hematocrit or
CBC
Urinalysis
Immunizations
Blood Pressure
Blood Sugar - Glucose
Blood Sugar - Glucose
Blood Sugar - A1c
Blood Sugar - A1c
Lipid Profile
Lipid Profile
Breast Exam
Pap Smear
Pap Smear* Not available after 65 years of age
Pelvic Exam
Mammogram
Bone Density
Prostate Specific Antigen
with Digital Rectal Exam
Stool for Occult Blood
Flexible Sigmoidoscopy
Colonoscopy
XPreventive Medicine Evaluation or Re-evaluation
One wellness visit per calendar year
As part of preventive medicine evaluation or
re-evaluation, preventive counseling as appropriate for age
or stage of development and risk factors.
XPreventive Medicine Evaluation or Re-evaluation
For ages 8 days through 35 months: 10 visits
As part of preventive medicine evaluation or re-evaluation, preventive counseling as appropriate for
age or stage of development
and risk factors.
XHemoglobin, Hematocrit or CBC
CBC performed at 12 months of age and once between ages 11-18.
XUrinalysis Once per calendar year.
XBlood Pressure Once per calendar year.
XBlood Sugar - Glucose Once per calendar year.
Annual glucose screenings are available for individuals ages 3-9 if at risk as defined as follows:
• Overweight or obesity (body mass index [BMI] > 85th percentile) and
• One or more of the following additional risk factors:
• First or second-degree relative with Type 2 diabetes
• Race/ethnic group: Native American, African American, Latino, Asian/Pacific Islander, Canadian First Nations, Australian indigenous
• History of maternal diabetes or gestational diabetes during the child's gestation
• Signs of insulin resistance or conditions associated with insulin or small for gestational age birth weight and/or length.
• Use of weight-promoting atypical antipsychotic drug
XBlood Sugar - Glucose Once per calendar year.
XBlood Sugar - A1c Once per calendar year.
Annual hemoglobin A1c screenings are available for at risk individuals ages 10-17. At risk individuals are defined as follows:
• Overweight or obesity (body mass index [BMI] > 85th percentile) and
• One or more of the following additional risk factors:
• First or second-degree relative with Type 2 diabetes
• Race/ethnic group: Native American, African American, Latino, Asian/Pacific Islander, Canadian First Nations, Australian indigenous
• History of maternal diabetes or gestational diabetes during the child's gestation
• Signs of insulin resistance or conditions associated with insulin or small for gestational age birth weight and/or length.
• Use of weight-promoting atypical antipsychotic drug
XBlood Sugar - A1c Once per calendar year.
XLipid Profile Once per calendar year.
Lipid profile screenings are available to high-risk individuals between the ages of 2 and
17.
High-risk individuals should have their first lipid profile screening before age 11.
A fasting lipid profile is the recommended screening method. High risk is defined as a family
history of high lipids
or early CVD; unknown history or other CVD risk factors such as overweight, obesity, hypertension or
diabetes.
XLipid Profile Once per calendar year.
A fasting lipid profile is the recommended screening method. High risk is defined as a family
history of high
lipids or early CVD; unknown history or other CVD risk factors such as overweight, obesity,
hypertension or diabetes.
XBreast Exam Once per calendar year.
XPap Smear Once every 3 to 5 years
Pap smears are available beginning at age 21.
For women ages 30 through 65 who wish to extend the time between pap smear screenings, a pap smear
will be covered every 5 years when it is
accompanied by HPV screenings.
For females 12-20, these services are available and may be covered under the appropriate medical
portion of your benefit plan. These should be
performed based on patient and provider discretion.
Pap smear screenings are not available after 65 years of age.
XPelvic Exam Once per calendar year Pelvic Exams are available annually for women over the age of 12. These should be performed
based upon patient and
provider discretion.
XMammogram Once per calendar year.
Mammograms are available for females ages 35 and older.
These should be performed based
upon patient and provider
discretion. Mammograms recommended every 2 years for ages 50-74.
XBone Density Once per lifetime.
XProstate Specific Antigen with Digital Rectal Exam Once
per calendar year.
Prostate cancer high-risk individuals are defined as follows:
• Between the ages of 40-49 and are African American, or have a father or brother diagnosed
with prostate cancer at a young age
XStool for Occult Blood Once per calendar year.
XFlexible Sigmoidoscopy Colonoscopy Flexible sigmoidoscopy
and colonoscopy
recommended for ages 45-75.
Additional screenings (flexible sigmoidoscopy, colonoscopy) for individuals considered to be at high
risk for colorectal cancer, as outlined below, may be covered under the appropriate medical portion
of your benefit plan. High-risk individuals in this category are defined as
follows:
• Strong family history of colorectal cancer or polyps (in first-degree relative younger than 60
or two first-degree relatives of any age). A first-degree relative is defined as a parent, sibling
or child.
• Known family history of colorectal cancer syndrome
• Personal history of colorectal cancer polyps
Gastroenterology consultations prior to colonoscopy are not covered under Healthy You!
Questions to Ask Your Doctor
What are my health numbers and how do they compare to the
recommended? What is one way I can improve my health? Can you describe my current health status? Are my screening tests up to date? Am I taking the lowest cost prescription drug available?
Immunizations
Select an age range to see recommended immunizations based on age and gender
guidelines. Talk with your Primary Care Network Provider about the purpose, frequency and importance
of staying current on immunizations.
Listed below are the immunizations covered under Healthy You! based
on age and gender guidelines. Ask your Primary Care Network Provider about the recommended number,
frequency and which immunizations are recommended for you.
Choose Age Range
Choose Age Range
Hepatitis B (Hep B)
(chronic liver inflammation, life-long complications)
Respiratory Syncytial Virus (RSV)
(birth to 24 months)
Respiratory Syncytial Virus (RSV)
(Pregnant women and age 60+)
The Value of Good Health and Being RxSmart
Leading a healthy lifestyle can make a big difference in your health and reduce the need for prescription
drugs. Eating a healthy, balanced diet,
along with regular exercise, being tobacco-free and seeing your doctor can keep you healthy. For those times
when prescription drugs are needed,
ask your Primary Care Network Provider to prescribe you the lowest-cost alternative available to meet your
needs.
Being RxSmart saves you money at the pharmacy.
$
$
Today, nearly 8 out of 10 prescriptions filled in the U.S. are for generic drugs.
All FDA-Approved generic drugs must be equivalent to the brand-name drug.
Many generic drugs are made in the same manufacturing plants as the brand-name drugs.
The generic manufacturer must prove its drug is the same as the brand-name drug.
The average cost of a generic drug versus its brand-name counterpart is 80-85% less.
be Tobacco-free
If you quit smoking, health improvements start right away and continue to get
better with time. If you've tried before, remember: every time you try to quit, you increase your chance of
succeeding.
Health Benefits of Being Tobacco-free
The health benefits of being tobacco-free can last a lifetime and can help you live a longer and
more productive life.
Improved reproductive health in both men and women
Whiter teeth and fresher breath
Healthier skin with more elasticity
Better sense of smell and taste
More energy
Reduced stress levels
Nonsmokers are half as likely to be at risk for stroke. Stroke is a disruption of blood
circulation to the brain that
can cause death or significant disability.
An estimated 8.6 million persons in the United States have serious illnesses attributed to
smoking; chronic bronchitis and emphysema
account for 59% of all smoking-attributable diseases. Being tobacco-free can increase lung
capacity 30 percent or more, which makes
everyday tasks like walking, exercise and taking the stairs easier.
Smoking
causes coronary heart disease, the leading cause of death in the United States. Cigarette
smokers are 2 to 4 times more likely to develop coronary heart disease than nonsmokers. Normal
heart rate and blood pressure promote good cardiovascular health.
Nonsmokers are 10 times less likely to develop Peripheral Artery Disease (PAD). Peripheral
Arterial Disease (PAD) in the legs or lower extremities is the narrowing or blockage of the
vessels that carry blood from the heart to the legs.
The Brain
Nonsmokers are half as likely to be at risk for stroke. Stroke is a disruption of blood circulation
to the brain that can cause death or significant disability.
The Lungs
An estimated 8.6 million persons in the United States have serious illnesses attributed to smoking;
chronic bronchitis and emphysema account for 59% of all smoking-attributable diseases. Being
tobacco-free can increase lung capacity 30 percent or more, which makes everyday tasks like walking,
exercise and taking the stairs easier.
The Heart
Smoking causes coronary heart disease, the leading cause of death in the United States. Cigarette
smokers are 2 to 4 times more likely to develop coronary heart disease than nonsmokers. Normal heart
rate and blood pressure promote good cardiovascular health.
The Circulatory System
Nonsmokers are 10 times less likely to develop peripheral artery disease (PAD). Peripheral Arterial
Disease (PAD) in the legs or lower extremities is the narrowing or blockage of the vessels that
carry blood from the heart to the legs.
Smoking
causes coronary heart disease, the leading cause of death in the United States. Cigarette
smokers are 2 to 4 times more likely to develop coronary heart disease than nonsmokers. Normal
heart rate and blood pressure promote good cardiovascular health.
