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Preventive health care guidelines summary

Our preventive health care guidelines summary provides you with information to help keep your family healthy.  Blue Cross and Blue Shield of Oklahoma provides these guidelines for information only. If you have specific questions regarding your health, consult with your physician. Contact the customer service number on your ID card, or refer to your summary plan description or member contract, for specific questions regarding benefit coverage.

Prenatal and Perinatal (1 month)

• Daily multivitamins with folic acid for all women planning pregnancy
• Screening for metabolic errors (phenylketonuria) for all newborns prior to discharge from nursery; repeat test prior to two weeks of age if initial test is before 24 hours of age
• ABO and D (formerly Rh) blood typing and antibody testing for all pregnant women at first prenatal visit and for all unsensitized D-negative women at 24-28 weeks, unless father is known to be D-negative
• Hepatitis B and rubella titers
  

Pediatric (1 month -— 2 years)

• General physical exam, extent determined by physician, performed at months: 1, 2, 4, 6, 9, 12, 15, 18 & 24
• Immunizations: Following is a summary--specific recommendations may vary depending on vaccine type and whether "catch-up" doses are needed
  

Pediatric (2 - 19 years)

• General physical exam, extent determined by physician, performed at years: 2, 3, 4, 5, 6, 10, 12, 14, 16 & 18
• Age appropriate health counseling covering tobacco use, sexual behavior, dental care, diet, nutrition, substance abuse, stress management, exercise, and injury prevention
• Testing for syphilis, gonorrhea and chlamydia, as necessary for those at risk for sexually transmitted diseases
• Pap smear annually for females who are or have been sexually active.
  

Adult (20 - 64 years)

• History and physical examination every two years, including blood pressure measurement (healthy males may have exam every five years, provided testicular self exam has been taught and is being done)
• Bimanual pelvic exam annually (female only)
• Digital rectal exam annually over age 50 at physician descretion
• Clinical breast exam annually over age 40 (female only)
• Diagnostic testing which includes
  • cholesterol every five years
  • screening mammography, every one-to-two years age 40-50, then yearly after age 50 (female only)
  • pap smear every 1-3 years based on risk factors (female only)
  • stool blood test annually over age 50
  • combined diphtheria and tetanus (Td) immunizations every 10 years and after potentially tetanus-contaminated wound if no immunization in previous five years
• PSA annually age 50 and older (male only)

Adult (65 and over)

• Pneumonia vaccine, one dose, all adults 65 and over
• Influenza vaccine for current year, yearly in autumn, all adults 65 and over
  

Select High-Risk Populations
(referral to specialist is appropriate for these high-risk patients)

• Fasting blood sugar, performed every three years if
  • family history of diabetes in first degree relative
  • more than 20 percent over ideal body weight
  • American Indian, Hispanic or African American
  • high blood pressure or high cholesterol
  • history of gestational diabetes or birth weight baby over nine pounds
• HIV test, annually or periodically for
  • male with male sex partner
  • IV drug use or history of IV drug use
  • male or female prostitute or multiple sex partners
  • HIV positive partner
• TB skin test (PPD) annually if
  • TB case exposure in the home
  • recent immigrant from country with high TB incidence
  • HIV positive, chronic renal failure or immunosuppressed condition
• Syphilis, gonorrhea or chlamydia tests as necessary for those at risk for sexually transmitted diseases
• Influenza vaccine for
  • residents of chronic care facilities
  • sufferers from chronic heart/lung diseases, metabolic diseases, sickle-cell anemia, Mediterranean anemia, immuno-suppression or renal dysfunction
  • health care providers
  • children and adolescents on long-term ASA therapy
  • pregnant women
  • Age 6 months - 23 months
  • > Age 65 and older
• Screening endoscopy for high-risk patients
  • hereditary colon polyps
  • ulcerative colitis
  • colon polyps
  • prior colon cancer
  • history of first degree relative with colon cancer
• PSA annually age 40 and older for high risk patients (male only)
  • family history
  • African American
• Pneumonia: Consider re-immunization every 6 years if asplenia, sickle cell anemia, immunocompromise, chronic cardiopulmonary disease, diabetes mellitus
• Bone Density Screening
  • High risk for osteoporosis
    Women with estrogen hormone deficiency; vertebral abnormalities, primary hyperparathyroidism or history of fragility bone fractures; receiving long-term glucocorticoid; or under treatment for osteoporosis (referral to specialist is appropriate for these high-risk patients)