Preventive screening guide for UPMC Health Plan members
When and where to get preventive screenings
Our preventive screening services have you covered as a UPMC Health Plan member—but how do you know which screenings you need? Here’s a list to help you find the ones that are right for you.
Everyone
Well-visits
Yearly
Well-visits are a basic preventive service. Your primary care provider (PCP) will discuss your health with you and check basic measures like:
Blood pressure
Yearly
Blood pressure measures the force of your blood against your arteries. High blood pressure (HBP) can cause serious conditions like heart disease. The most common risk factors for HBP are age, race, and chronic kidney disease.
Blood sugar
Yearly
It’s important to be aware of your blood sugar levels. They vary with your eating habits, physical activity habits, alcohol use, and stress. Having too much glucose in your blood can lead to diabetes.
Cholesterol screening
Yearly (or as recommended)
Cholesterol screenings help check your risk of heart disease, stroke, and poor circulation. Cholesterol is measured through a blood test.
Body mass index
As needed
Body mass index (BMI) is a measure of your health and potential risks. It takes height and weight into account.
Flu shot
Yearly
Healthy people can still get the flu and spread it to others. The Centers for Disease Control and Prevention (CDC) urges everyone to get an annual flu shot. UPMC Health Plan covers the cost of the flu shot for all members. We encourage you to get your free flu shot this season!
Mental health
As needed
Your mental health is an important part of your well-being. You should get screened for depression, anxiety, or other mental health symptoms if you feel you need to. UPMC Health Plan offers programs and services to help you manage your behavioral health. Speak with your PCP about issues you may be having.
People over 50
Colorectal cancer screening
Every year (FIT test), five years (sigmoidoscopy), or 10 years (colonoscopy)—Everyone ages 45-75 years
Colorectal cancer is easier to treat when it’s found early. There are a few options for colorectal cancer screenings. Talk to your doctor about the test that’s right for you.
Breast cancer screening (mammography)
Every two years—People who were assigned female at birth (AFAB) ages 50-74 years
As needed for others
Breast cancer screenings can help you find breast cancer early. Screenings are recommended every two years for AFAB people ages 50-74 years old. Transgender women, cisgender men, and intersex people may also need breast cancer screenings depending on personal risk factors. Consult your PCP to see what is recommended for you. Learn what to expect.
Osteoporosis screening
One time—AFAB people 65 and older (or under 65 if at increased risk)
The one-time DEXA scan uses an ultrasound to measure bone density. DEXA scans are quick and painless. They take low-dose x-rays of the hip and spine to help you know if you need treatment.
Lung cancer screening
Yearly if at risk
This screening detects lung cells that may be cancerous. Talk to your doctor about getting this test if you meet the following criteria:
- Are 55-80 years old
- Have a history of smoking
- Have quit smoking within the past 15 years
Vision and hearing
Yearly
Talk to your doctor about changes in your vision and hearing as you age. If you have a prescription for lenses, make sure to get your vision checked regularly. Your PCP will let you know how often to get your hearing checked.
People 21 and over
Cervical cancer
Every three years (Pap test)—AFAB people ages 21-65 years
Every five years (Pap with primary hrHPV)—AFAB people ages 30-65 years
AFAB people with uteruses should get a Pap test every three years or a Pap test with an hrHPV test every five years until age 65. We know cervical cancer screenings can be uncomfortable. However, making time for this screening is important. When caught early, cervical cancer is treatable.
Prediabetes
Yearly
Prediabetes usually has no symptoms. It’s a good idea to talk to your doctor about prediabetes if you have any of the following:
- A BMI over 25
- A family history of diabetes
- HBP or cholesterol
Remember, UPMC Health Plan offers members Prescription for Wellness health coaching at no cost. Health coaches can help you set and reach health goals that can help you reduce your risk.
For more information about screenings, check out Preventive Screenings 101. For a full list of preventive services covered by UPMC Health Plan, call the number on your member ID card or review the Preventive Service Reference Guide.
Need help finding care?
UPMC Health Plan offers various convenient options for members to get covered care and screenings.
Do you have questions or concerns about your coverage? Our Health Care Concierge team can help.
To reach a Health Care Concierge, call the number on your member ID card Monday through Friday from 7 a.m. to 7 p.m. or Saturday from 8 a.m. to 3 p.m. You can also chat with a Health Care Concierge by logging in to MyHealth OnLine.
