Commonwealth Care Alliance

Senior Care Options Program (HMO SNP)

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Preventive Care Guidelines

Adult Routine Preventive Care Guidelines

We at Commonwealth Care Alliance want you to enjoy good health. Eating healthy food, exercising regularly, and working with your doctor all help you to live a longer and happier life.

You can be even healthier by preventing disease. Many of our members, however, find it harder to prevent disease. Aging, physical disability, mental health conditions, and addictions make it even harder. You may also be the guardian of a member who needs your help to make sure they get the preventive care they need. Being healthy is harder for some, and we can help.

Because of these challenges, many of our members are sicker than they need to be. Dental checkups, Pap smears, mammograms, and colonoscopies are all tests that people need to stay healthy. Individuals with disabilities are much less likely to get these tests than other people. By working together with your doctor, you can get the tests you need and improve your health.

Here you will find some recent changes in preventive care recommendations. Reviewing this list will bring you up-to-date on these important changes. We also  provide a table with a summary of routine preventive care recommendations for adults.

Ten things you should know about recently updated preventive care recommendations

  1. Blood pressure for people with diabetes: Your numbers need to be 140/90 or lower to best prevent kidney failure, stroke, and heart disease.
  2. Cholesterol testing and treatment: Get tested at least every 5 years. If your doctor says you have risks for future heart disease, you may be prescribed a cholesterol-lowering medication, especially if you have already had a heart attack or a stroke.
  3. Diabetes test: Get tested every 1 to 5 years depending on your risks – be sure to ask your doctor. The earlier we catch diabetes, the more you can do to stop it.
  4. Cervical cancer tests: Testing is done MUCH less often now. In fact, no one gets a Pap smear before age 21. Then, testing occurs every 3 years until age 30, then every 5 years, with HPV (genital wart virus) testing until age 65. You can prevent and cure cervical cancer with regular Pap smears.
  5. Mammography: Because the test does not work well in younger women, we usually begin testing at age 50. Mammograms are given every 2 years from age 50 to 75 years old. If you think you should start at age 40, talk to your doctor.
  6. Colon and rectal cancer testing (colonoscopy): It is recommended that you have your colon examined every 10 years beginning at age 50. If you cannot tolerate a colonoscopy, testing your stools for blood every year is one alternative.
  7. Prostate cancer screening: Most experts agree that routine screening for prostate cancer isn’t necessary. A rectal exam and/or blood test is ONLY recommended from 55 to 70 years old and ONLY if you discuss it with your doctor and agree on the risks and benefits for you.
  8. Hepatitis C screening: Get tested at least once. There are new, much better, treatments available. Also, avoid unsafe sex, sharing needles, and any other blood contact which is how the virus is transmitted.
  9. Abdominal aortic aneurysms: An ultrasound picture of your abdomen is recommended for every MAN age 65-75 who has ever smoked. The test checks to see if there is any dangerous ballooning of the artery. It is a painless test that some doctors offer right in their offices.
  10. Advance care planning: Everyone should have a MOLST (Medical Orders for Life Sustaining Treatment) and Health Care Proxy form filled out and signed. This way your doctors will know what types of life-sustaining treatment you want when you are too sick to tell people yourself. If you can, post the forms on your refrigerator door so they can be easily located.

Summary of routine preventive care recommendations for adults

WHAT

WHY

WHEN

IS THIS FOR ME?

ROUTINE TESTS To prevent diseases or detect them early enough to prevent complications and keep you in good health. Based on USPSTF and CDC Guidelines* What tests or treatments are right for you depend on your age, overall health, and what you value most in life.
PHYSICAL EXAM During a physical examination, your doctor can review your health status and find health problems before they hurt you. Every 1-3 years
18-49Yearly 50+
Everyone should have an exam every few years. Go more often if you are over 65, have chronic diseases, or risks.
WEIGHT/BODY MASS Getting your weight down to what’s best for your height will help you feel healthier and help prevent diabetes and heart disease. Yearly 18+ Unintended weight gain and weight loss are signs of a potential problem. If you are a wheelchair user and cannot be weighed on the scale in your doctor’s office, ask your doctor for help.
BLOOD PRESSURE Lower blood pressure helps reduce your risk of stroke, kidney failure, heart disease, and blindness. Every visit 18+ ·        If you are under 65, your blood pressure should be under 140/90.·        If you are over 65, your blood pressure should be under 150/90.·        If you have diabetes (at any age), your blood pressure should be under 140/90.
EYE EXAM Regular eye exams can help find cataracts, diabetes, glaucoma, and other diseases early enough to save your vision. Every 1-3 years 40+ If you have high blood pressure, high cholesterol, diabetes, or glaucoma, talk to your doctor about seeing an eye care specialist.
CHOLESTEROL TEST High cholesterol can clog your arteries. This can cause strokes, heart attacks, and leg pain. Healthy eating, exercise, and medications can help. Every 5 years18+ If you have diabetes, high blood pressure, or other risks for heart disease and stroke, your doctor may test you more often.
DIABETES TEST Regular testing can help find diabetes early. Early treatment with diet, exercise, or medications can help prevent complications such as kidney failure, blindness, leg pain, heart disease, and more. Every 3 years 45+ Testing should start earlier, and it should be done more often if you are overweight or have a family history of diabetes, high blood pressure, high cholesterol, or heart disease.
HIV/HEPATITIS TEST Health experts recommend testing for HIV and Hepatitis infections at least once in each person’s life. At least
once 18+
You should be tested more often if you engage in unprotected sex or share needles to inject drugs.
PAP SMEAR/HPV TEST FOR CERVIAL CANCER Pap smears help find cervical changes before they become cancer. Pap smears are the best test doctors have to find and cure cancer. Every 3 Years 21-29
Every 5 years 30-65
Sexually active women should start pap smears at age 21 and repeat every 3 years. Starting at age 30, move to every 5 years (with HPV virus testing included). Continue testing until age 65.
MAMMOGRAM FOR BREAST CANCER Periodic mammograms may help find breast cancer early, allowing for earlier treatment, which may prolong life. Every 2 years
50-74
All women should have a mammogram periodically. Ask your doctor if you should start at age 40 or continue past age 74 if you have risks
COLONOSCOPY
FOR COLON CANCER TESTING
A colonoscopy can help find tumors before they become cancer. These and early cancers can be completely removed and cured this way. Every 10 years 50-75 Have a colonoscopy every 10 years. However, a colonoscopy may be a risky procedure for some frail elderly people. Talk to your doctor about alternative tests.
ABDOMINAL AORTIC ANEURYSM TESTING A painless ultrasound picture of your stomach can find a dangerous swelling of your largest artery and save your life. Once 65-75 This screening is only helpful for MEN who have EVER SMOKED.
BONE THICKNESS TEST Simple bone thickness tests can detect bone thinning (osteoporosis), which can be treated with medications to prevent bone loss. This can reduce your risk of painful, disabling bone breaks. Once 65+ All women should be tested at least once. Start earlier if you are at higher risk of osteoporosis and fractures. Important risks include: family history, Caucasian/Asian race, low body weight, and smoking.
VACCINATIONS You can prevent disease with vaccines against tetanus (every 10 years), flu (every fall), pneumonia (once), and shingles (once). Check with your doctor about these vaccines.
ROUTINE COUNSELING These are several important topics to discuss with your care team that can help you continue your healthy habits and make the positive changes in your life. Some important topics for you to discuss may include: tobacco use, alcohol and drug use, and domestic abuse
ADVANCE CARE PLANNING Make sure you receive the care you want – even if you are unable to communicate your wishes. Your doctor can help. Review Yearly Everyone should work with their doctor to complete and sign a MOLST (Medical Orders for Life Sustaining Treatment) and Health Care Proxy form.

*United States Preventive Services Task Force and the Centers for Disease Control

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Last Updated 06/09/2015