Guidelines for Preventive Services: Exams and Screenings
Preventive services, including exams and screenings, play a huge role overall physical health. They can detect problems early — which can be life-saving. One important perk of being a UPMC Health Plan member: Initial preventive exams and screenings are available to you at no cost! So why not take advantage of them?
These are (just a few of) the preventive exams and screenings available and a helpful guide on when and how often you should receive them. Call the number on your member ID card to hear about all covered screenings and get help with scheduling if needed.
General physical
Once a year
- Primary care provider (PCP) can assess for additional screenings including:
- Blood pressure
- Depression screening
- Intimate partner violence
- Lifestyle topics
- Tobacco use
- Alcohol misuse
- Skin cancer
- Sexually transmitted infection counseling with any additional screenings for members with increased risk (e.g., chlamydia, gonorrhea, syphilis)
- Contraception
- HIV screening
- Hepatitis B screening
Blood cholesterol screening
Every 5 years beginning at age 20
Cervical cancer screening
Pap Test every 3 years for members ages 21-65 or
Combined Pap Test/Human papillomavirus (HPV) DNA test every 5 years ages 30-65
Colorectal cancer screening
Every 1-10 years based on risk beginning at age 50
- Fecal occult blood testing every year
- Sigmoidoscopy every 5 years
- Colonoscopy every 10 years to age 75
Breast cancer screening (mammography)
Recommended every 2 years for members ages 50-74 but
Covered annually for members 40 and up
Type 2 diabetes
Every 3 years beginning at age 19 for members with high blood pressure
Flu shot
Yearly
Lung cancer screening
Annually for members ages 50-80 with a history of heavy smoking (1 pack a day for 30 years or 2 packs a day for 15 years) who currently smoke or have quit within 15 years
BRCA screening and counseling
One-time genetic test for members with family history of breast or reproductive cancer, as recommended by doctor
Members with positive screening should receive genetic counseling
Osteoporosis screening
One-time screening for members 65+ or members younger than 65 with increased risk
For a full list preventive screenings, immunizations, and exams covered by UPMC Health Plan, call the number on your member ID card. Additional coverage includes multiple immunizations, screenings throughout pregnancy, services for children, preventive medications for tobacco cessation, and more.
