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Covered PREVENTIVE CARE SERVICESPREVENTIVE CARE SERVICES CHART

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Screenings, Counseling and Tests


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Adults 
Alcohol misuse age 18 or older - screening with brief behavioral counseling interventions
Blood pressure screening  all adults 
Cholesterol screening  
  • all men 35 and older
  • men ages 20 to 35 who have heart disease or risk factors for heart disease
  • women age 20 and older who have heart disease or risk factors for heart disease 
Colorectal cancer screening  over 50 - once every 5 years 
Diabetes screening ages 40 - 70 who are overweight or obese
Depression screening screening for adults, including pregnant and postpartum women
Healthy diet counseling all adults at higher risk for chronic disease
Healthful diet/physical activity  behavioral counseling for cardiovascular disease prevention  
Hepatitis B screening all adults at high risk
Hepatitis C screening all adults at increased risk, and once for everyone born 1945 - 1965
High blood pressure screening  age 18 or older - measurements outside of a clinical setting for diagnostic confirmation before starting treatment
HIV screening ages 15 to 65, and other ages at higher risk
Lung cancer screening ages 55 to 80 at high risk for lung cancer due to smoking or have quit within 15 years
Type 2 diabetes mellitus screening ages 40 to 70 who are overweight or obese 
Tobacco use  screening for all adults; cessation interventions for tobacco use
Syphilis screening  all adults at higher risk
 Sexually transmitted infection (STI) behavioral counseling for adults at higher risk 
Women 
Anemia screening pregnant women on a routine basis
Bacteriuria pregnant women - urinary tract or other infection screening
BRCA women at higher risk - counseling about genetic testing
Breast cancer chemoprevention counseling   women at higher risk
Breast cancer mammography over 40 -  screenings every 1 to 2 years
Breast feeding comprehensive support, counseling and supplies
Cervical cancer screening   all sexually active women
Contraceptive methods approved by the FDA barrier, short-acting hormonal, contraceptive injection, emergency and permanent sterilization
Contraceptive counseling all sexually active women
Chlamydia infection screening younger women and others at higher risk 
Gestational diabetes mellitus screening asymptomatic pregnant women after 24 weeks of gestation
Hepatitis B screening pregnant women at first prenatal visit
Human papillomavirus age 30 or older with normal cytology results - DNA testing every 3 years  
Osteoporosis screening over 60 - depending on risk factors
Rh incompatibility screening pregnant women, and follow-up testing for women at higher risk
Interpersonal and domestic violence    all women - screening and counseling
HIV  all sexually active women - screening and counseling
Syphilis screening  pregnant women and others at increased risk 
Tobacco use  screening and interventions for all women; expanded counseling for pregnant tobacco users 
Well-woman visits  under 65 
Men 
Abdominal aortic aneurysm ages 65 to 75 - one-time screening for men who have ever smoked
Prostate cancer screening all men
Pediatric (Children & Adolescents) 
Alcohol and drug use assessment all adolescents
Autism screening at 18 months and 24 months
Behavioral assessment all children 
Cervial dysplasia screening  all sexually active females 
Depression screening  all adolescents 
Dental caries screening  infants to age 5 - for prevention 
Developmental screening  under age 3, and surveillance throughout childhood 
Dyslipidemia screening children at higher risk of lipid disorders 
Height, weight and body mass index (BMI) measurement  all children 
Hematocrit or hemoglobin screening  all children 
Hepatitis B screening  adolescents at high risk 
HIV screening  adolescents at high risk
Lead screening    children at risk of exposure 
Medical history  all children throughout development 
Obesity   all children - screening and counseling 
Oral health  risk assessment for young children 
Sexually transmitted infection (STI)  behavioral counseling for adolescents at higher risk 
Tuberculin testing  children at higher risk of tuberculosis 
Vision testing  all children 
Pediatric (Newborn) 
Congenital hypothyroidism screening all newborns
Hearing screening all newborns
Hemoglobinopathies/sickle cell screening  all newborns 
Hypothyroidism screening all newborns 
Gonorrhea preventive medication  for the eyes of all newborns 
Phenylketonuria (PKU) screening  all newborns 


Immunization Vaccines


Adults (doses, ages and populations vary)
Pediatric : birth to age 18 (doses, ages and populations vary) 
Hepatitis A Diphtheria, tetanus, pertussis
Hepatitis B Haemophilus influenzae type B
Herpes zoster  Hepatitis A 
Human papillomavirus  Hepatitis B 
Influenza  Human papillomavirus 
Measles, mumps, rubella  Inactivated poliovirus 
Meningococcal   Influenza 
Pneumococcal   Measles, mumps, rubella
Tetanus, diphtheria, pertussis  Meningococcal 
 Varicella   Pneumococcal
   Rotovirus
   Varicella

Pharmacy Services


Adults 
Aspirin use to prevent cardiovascular disease
  • men ages 45 to 79
  • women ages 55 to 79
  • low-dose for women after 12 weeks of gestation who are at risk for preeclampsia
  • over the counter (OTC) with prescription
Bowel preparation agents for colorectal cancer screening generic and OTC
Vitamin D OTC supplementation products (single ingredient only with prescription) 
Smoking cessation products prescription and OTC (with prescription) 
Women
Folic acid supplements women who may become pregnant; OTC (with prescription only)
Low-dose aspirin  as preventive medication after 12 weeks gestation in women at high risk for preeclampsia
Pediatric
Fluoride supplements children older than 6 months without fluoride in their water source; with prescription (generic single ingredient only)
Iron supplements children ages 6 to 12 months at risk for anemia