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Preventive Healthcare Guidelines

Preventive Healthcare Guidelines

Children

 

Infancy- Age 1

Ages 1-10

Ages 11-20
Tot-to-Teen Health Check

(complete examination that includes vision, hearing, development, and behavioral health screening)

 Visit your PCP for this complete exam when your child is 1, 2, 4, 6, 9, and 12 months of age. Visit your PCP for this complete exam when your child is 15, 18, and 24 months, and 3, 4, 5, 6, 7, 8, 9 and 10 years of age. Visit your PCP for this complete exam when your child is 11, 12, 13, 14, 15, 16, 17, 18, 19, and 20 years of age.
Blood lead screening

At 12 months

At 24 months

  
Laboratory tests

Ask your PCP if your child needs any laboratory tests
Immunizations

Ask your PCP or nurse at every office visit if your child needs immunizations. (See immunization schedule (.pdf) or Programa de Vacunas para los Niños y los Adolescentes que "Hecho al Año" (.pdf)
Cervical Cancer screening     Pap smear testing with onset of sexual activity, but at least by age 21. Then every 1-3 years as recommended by your PCP.
Screening for Chlamydia (a curable sexually transmitted disease that can lead to infertility)     All sexually active females 25 and younger and for others at increased risk. Discuss with your PCP.
Screening for rubella     Once for all females of childbearing age by history of vaccination or blood test.
Health Education and Counseling Members from infancy to age 20 should get age-appropriate health education and counseling at every visit on topics such as:

Regular physical activity

Healthy diet

  • Breastfeeding
  • Iron-enriched formula (less than age 1)
  • Limit fat and cholesterol, maintain caloric balance, emphasize grains, fruits, vegetables (2 years and older)
  • Adequate calcium intake
  • Multivitamin with folic acid (females planning/capable of pregnancy)

Prevention of injuries (motor vehicle, household and recreational)

  • Child safety car seats (less than 5 years)
  • Lap/shoulder belts (5 years and older)
  • Bicycle/motorcycle/All Terrain Vehicle (ATV) helmets
  • Airbag safety
  • Smoke detectors
  • Flame retardant sleepwear (less than 11 years)
  • Hot water temperature less than 120-130 degrees F
  • Window/stair guards, pool fence
  • Safe storage or removal of drugs, toxic substances, firearms, and matches
  • Poison control phone number
  • Cardiopulmonary Resuscitation (CPR) training for parents and caretakers

Dental care/baby bottle tooth decay

Sleep positioning for infants

Not using/quitting tobacco/secondhand smoke

Prevention of illegal drug use and underage drinking

Prevention of Human Immunodeficiency Virus (HIV) and other sexually transmitted diseases (STDs)

Prevention of unintended/mistimed pregnancies


 

Adults

 

Ages 21-64

Ages 65 and older
Breast cancer screening Mammogram (special x-ray of breast) every 1-2 years for women 40 and older.
Cervical cancer screening Pap smear testing with onset of sexual activity, but at least by age 21. Then every 1-3 years as recommended by your PCP.
Screening for Chlamydia

(a curable sexually transmitted disease that can lead to infertility)

 All sexually active women 25 and younger and for others at increased risk.

Discuss with your PCP.

  All sexually active women at increased risk.

Discuss with your PCP.
Screening for colorectal (intestine/gut) cancer By testing for blood in stool every year for everyone 50 and older. Discuss sigmoidoscopy or colonoscopy with your PCP.
Screening for Type 2 Diabetes

Discuss with your PCP.
Blood pressure check

At least every 2 years
Lipid/cholesterol testing At least every 5 years for men ages 35 and older.

At least every 5 years for women 45 and older.
Screening for osteoporosis (bone thinning)   For women ages 65 and older. Discuss with your PCP.
Screening for abdominal aortic aneurysm (a heart problem)   Men ages 65-75 who have ever smoked (one-time test).
Height, weight, and obesity

By measuring height, weight, and Body Mass Index (BMI) at every office visit.
Screening for rubella Once for all women of childbearing age by history of vaccination or blood test.  
Testing for tuberculosis

Discuss with your PCP.
Screening for depression

Discuss with your PCP.
Screening for behavioral health problems (mental health and drug abuse)

First PCP visit.
Testing for hearing and vision problems   Discuss with your PCP.
Immunizations (shots)

Tetanus boosters. Ask your PCP about other immunizations you may need.
  Flu shot every year for everyone age 50 and older and adults at-risk.
  Shingles (Herpes Zoster) vaccine for ages 60 and older (one-time vaccine).
    Pneumococcal vaccine
Health Education and counseling

You should get age-appropriate health education and counseling at every visit on topics such as:

  • Not using/quitting tobacco
  • Regular physical activity
  • Healthy diet (limit fat and cholesterol, maintain caloric balance, emphasize grains, fruits, vegetables)
  • Adequate calcium intake
  • Multivitamin with folic acid (females planning capable of pregnancy)
  • Dental care

Prevention of injuries (motor vehicle, household, and recreational)

  • Lap/shoulder belts
  • Bicycle, motorcycle, and All Terrain Vehicle helmets
  • Avoid alcohol/drug use while driving swimming, boating, etc.
  • Safe storage or removal of firearms
  • Hot water heater less than 120-130 degrees F (65 years and older)
  • Cardiopulmonary Resuscitation (CPR) training for household members (65 years and older)
  • Fall prevention (65 years and older)

Prevention of HIV infection and other sexually transmitted diseases (STDs)

Birth control

Discussion of prevention of chronic diseases for perimenopausal and postmenopausal women

Discussion of aspirin for members at risk for heart disease


 

Pregnancy

  • Visit a practitioner as soon as you think you might be pregnant.
  • Your practitioner will tell you how often you need to visit after your first visit, usually every four weeks until your last trimester, then every two weeks, and then every week during the last month.
  • You will need to visit your practitioner again 4-6 weeks after you deliver your baby.
  • Follow these guidelines in addition to those listed for your age.

Screenings

 Blood, urine, and other tests that will check the health of you and your baby

Education and Counseling
  • Tobacco cessation/effects of passive smoking
  • Alcohol/other drug use
  • Nutrition, including adequate calcium intake
  • Multivitamin with folic acid
  • Breastfeeding
  • Lap/shoulder belts
  • Infant safety car seats
  • Sexually transmitted disease (STD) prevention
  • Importance of postpartum visit (follow-up visit after baby is born)
  • Birth control (at postpartum visit)
Immunizations (shots) Flu shot (ask Primary Care Practitioner)
Rubella after delivery, if needed


 

1. State of New Mexico Medical Assistance Division, New Mexico Administrative Code 8.305.8.16 “Standards for Preventive Health Services”
2. Tot-to-Teen Health Checks are federally mandated for Medicaid as part of Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Program Services
3. U.S. Preventive Services Task Force, Guide to Clinical Preventive Services, 2006, and pertinent updates
4. Guidelines for Perinatal Care, 5th Edition, October 2002, AAP/ACOG (www.acog.org)
5. “Recommended Childhood and Adolescent Immunization Schedule – United States, 2007-2008;” Approved by the Advisory Committee on Immunization Practices (http://www.cdc.gov/vaccines/recs/acip/default.htm), the American Academy of Pediatrics (http://www.aap.org), and the American Academy of Family Physicians (http://www.aafp.org/online/en/home.html)

*Subject to Medicare coverage guidelines