Preventive Care Coverage: Adults

Adult well-care visits — also called preventive care — are included benefits in most Group Health Cooperative and Group Health Options, Inc. plans. Preventive care coverage varies by plan.

Also see: Preventive Care Coverage: Children

Screening Schedules

Immunization Schedules

AGES 18 to 21 Well-care visit every year

For women:
First Pap test 3 years after becoming sexually active or by age 21, whichever comes first

Chlamydia test every year for sexually active women up to age 25*

For men:
No routine screenings recommended for men in this age group.

Tetanus-diphtheria every 10 years**

Pneumococcal vaccine for high-risk groups

Flu vaccine every year

Hepatitis A and Hepatitis B vaccines for those at high risk of infection

AGES 22 to 49 Well care visit every 4 years

For everyone:
Blood pressure check every 2 years

For women:
Pap test every 2-3 years

Chlamydia test every year for sexually active women up to age 25*

Mammogram every 1 or 2 years, based on risk factors or personal choice, beginning at age 40

Cholesterol check every 5 years, beginning at age 45

For men:
Cholesterol check every 5 years, beginning at age 35.

Tetanus-diphtheria every 10 years**

Pneumococcal vaccine for high-risk groups

Flu vaccine every year

Hepatitis A and Hepatitis B vaccines for those at high risk of infection

AGES 50 to 64 Well care visit every 2 years

For everyone:
Cholesterol check every 5 years

Blood pressure check every 2 years

Colon cancer screening: talk with your doctor about the best method for you

For women:
Pap test every 2-3 years

Mammogram every 1-2 years according to risk for breast cancer or personal choice

Osteoporosis screening: women age 60-64 with risk factors, discuss with your health care provider

For men:
Discuss prostate cancer screening with your health care provider

Tetanus-diphtheria every 10 years**

Pneumococcal vaccine for high-risk groups

Flu vaccine every year

Hepatitis A and Hepatitis B vaccines for those at high risk of infection

Shingles vaccine, unless immune suppressed, once in a lifetime for ages 60 and over

AGES 65+: Well care visit every 2 years

For everyone:
Blood pressure check every 2 years

Cholesterol check every 5 years through age 74; after age 75 discuss with your doctor

Colon cancer screening: talk with your doctor about the best method for you (If aged 75 and older, discuss screening schedule with your doctor)

For women:
Mammogram every 1-2 years according to risk for breast cancer; women age 75 and over, discuss screening schedule with your health care provider

Osteoporosis screening: discuss with your health care provider

For men:
Discuss prostate cancer screening with your health care provider

Abdominal aortic aneurysm screening: One-time screening for men 65 to 75 who have ever smoked cigarettes.

Tetanus-diphtheria every 10 years**

Pneumococcal vaccine one time for ages 65 and over

Flu vaccine every year

Hepatitis A and Hepatitis B vaccines for those at high risk of infection

Shingles vaccine, unless immune suppressed, once in a lifetime for ages 60 and over

* Women over 25 who are at high risk for having an STD also should be screened. Ask your primary care provider what screening schedule is best for you. If you are pregnant, talk to your primary care provider about the need for chlamydia testing.

** Once as an adult, everyone should get a tetanus-diphtheria (Td) booster that contains pertussis (Tdap).

Remember that the focus of the visit schedules listed above is preventive care. If your doctor orders tests or services beyond the scope of a well visit, there may be additional costs according to your benefit plan.

Clinical review by:
Travis Abbott, MD
Group Health
Reviewed 05/05/2010

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Preventive Care Coverage: Adults