Medicare Advantage (HMO SNP)

Preventive Health Guidelines 2012

HOW TO STAY HEALTHY

Sources for all information in this document: Centers for Medicare and Medicaid Services, U.S. Preventive Services Task Force and Centers for Control and Disease Prevention (2012).

L.A. Care Health Plan is a Coordinated Care Plan with a Medicare Advantage contract and a contract with the California Medicaid program. LA0730 04/12

What you can do to stay healthy! Don’t smoke or quit smoking

Eat well balanced meals

Exercise

Get needed tests/exams

Keep a healthy weight

See your doctor on a regular basis and after hospitalizations

Spend time with family and friends

Stay connected with people

Well Care Guidelines for Adults*

Tests/Exams 19 to 39 Years 40 to 64 Years 65+ YearsInitial “Welcome to Medicare Visit” One time (within 12 months of the start of Medicare benefit)

Abdominal Aortic Aneurysm(Screening Ultrasound)

One-time screening, if referred and part of the “Welcome to Medicare Visit” or if you are at risk

Electrocardiogram (EKG) Screening One-time screening, if referred and part of the “Welcome to Medicare Visit”

“Wellness” Visit: Medical and family history, physical exam,

height, weight, blood pressure, and BMI (a measure for weight concerns)

Every year

Bone Mass Measurements(to check risk for breaking bones) Every 2 years (if at risk)

Cardiovascular Screening: (to check risk for heart attack or stroke by

checking cholesterol, lipids, and triglyceride levels) Every 5 years

Colon and Rectal Cancer Screening (to check for colorectal cancer)

Age 50 and older Your doctor will talk to you about having one or more of these tests:• FecalOccultbloodtest[a test to see if there is blood in your stool

(bowel movement)]: every year • FlexibleSigmoidoscopy(a test of the lower part of your colon):

every 4 years (after the last Flexible Sigmoidoscopy) or every 10 years (after a previous Screening Colonoscopy) • ScreeningColonoscopy(a test of a larger part of your colon):

every 10 years • BariumEnema:every4years(every 2 years if at high risk)

Diabetes Screening(to check for diabetes and pre-diabetes) If at risk

Diabetes Self-Management Training If you have diabetesGlaucoma Test

(to measure eye pressure) Every year (if at risk)

Human Immunodeficiency Virus (HIV) Screening

(to check for the virus that causes HIV infection)Every year (if at risk or requested)

MedicalNutritionTherapy If you have diabetes or kidney disease or kidney transplant in the last 3 yearsTobacco Cessation

(Stop smoking and tobacco use) 8 visits during a 12-month period

* Your doctor may recommend other screenings or immunizations (shots), if you are at high risk.

This information is available for free in other languages. Please contact our customer service number at 1-888-522-1298 for additional information. TTY/TDD users should call 1-866-522-2731. We are available 24 hours a day, 7 days a week (including holidays).

Esta información está disponible de forma gratuita en otros idiomas. Por favor, comuníquese con el departamento de servicios para miembros al 1-888-522-1298 para obtener información adicional. Los usuarios de TTY deben llamar al 1-866-522-2731. Estamos disponibles las 24 horas del día, los 7 días a la semana, (incluso los días festivos).

Plan member materials are available in different languages or formats, including large print, audio, and Braille or upon request.

Los materiales para miembros del plan están disponibles en otros idiomas o formatos como letra grande, audio, y braille a su solicitud.

Member Services toll free24 hours a day, 7 days a week, including holidays.1-888-522-1298 TTY 1-866-522-2731

Nurse Advice Line 24/7 for health questions24 hours a day, 7 days a week.1-800-249-3619 TTY 1-800-854-7784

Websitewww.lacare.org

Other Well Care Guidelines to Stay HealthyTests/Exams 19 to 39 Years 40 to 64 Years 65+ Years

Alcohol Misuse Screening Once a year

Hearing and Vision As recommended

DentalExam As recommended

DepressionScreening Once a year

Obesity Screening and Counseling If you are overweight and have a body mass index (BMI) of 30 or more

Tuberculosis (TB) Test and Risk Screening Recommended for all adults as part of their first checkup Doctors will also screen those at a higher risk for TB

Well Care Guidelines for MenTests/Exams 50+ Years

Prostate Cancer Screening Every Year

Well Care Guidelines for WomenTests/Exams 16 to 39 Years 40 to 64 Years 65+ Years

Breast Cancer Screening (Mammogram an X-ray

of the breasts)

One time baseline screening for ages 35-39, then every year after 40

Cervical and Vaginal Cancer Screening (Pelvic exam and Pap smear

to check for cancer)

Every 24 months or every 12 months if at risk or a previous test showing cancer or an abnormal test in the past 3 years (ages 21-65 as recommended)

Chlamydia Screening [a test for a sexually

transmitted disease (STD)]

To be done regularly for women 16 to 25 years (up to their 26th birthday) and only for women who are at high

risk over 25

If at risk

Osteoporosis (thinning of the bone) As recommended Screening for 65+

Going to your doctor for regular wellness visits helps you stay healthy. This guide

tells you when to go and what needs to be done at these visits. Your doctor is

always a good resource for you and your family. You can ask questions and get

advice about important health topics.

Ask your doctor which tests/exams are right for you.

Immunizations/Shots for Adults*Immunizations (Shots) 19 to 39 Years 40 to 64 Years 65+ Years

HepatitisB(A disease of the liver) If at risk

HumanPapillomaVirus(HPV)(Virus can cause cervical cancer

and genital warts)

For women up to age 26 and men up to age 21, if not immunized before (3

doses)

—

Influenza (Flu)(Influenza or flu virus)

Every year (During flu season in fall or winter)

Measles,Mumps,andRubella (MMR) If born after 1957 (1 or 2 doses) —

Pneumococcal(Bacteria can cause lung or blood infection) — One dose

Shingles (Herpes Zoster)(Virus can cause painful skin rash with blisters) — One dose, starting at

age 60

Tetanus,Diphtheria,Pertussis (Td/Tdap) (Lockjaw tightening of the jaw muscle)

Substitute 1-time dose of Tdap for Td booster; then boost with Td every 10 yrs

Td booster every 10 years

* Your doctor may recommend other screenings or immunizations (shots), if you are at high risk.

•Aspirin

•Asthma

•Bladder Control

•Dental Health

•Depression

•Diabetes

•Drug and Alcohol Problems

• Exercise• Fall Prevention• Family Planning/

Birth Control•How to

Quit Smoking•How to

Stay Healthy•Your Medication(s)

•Mental Health Concerns (memory loss or changes)

•Nutrition

•Pain Management

•Parenting

• Safety Tips

• STDs and HIV

•Violence and Abuse

•Weight Concerns

•Any other concerns you may have

HOW TO STAY HEALTHY

You may also talk to your doctor about: (circle the ones you want to talk to your doctor about)

If you are a new member, see your

doctor right away for your first “Welcome

to Medicare Visit.” Remember to go

for a wellness visit every year. Regular

wellness visits help you stay healthy!