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Going to Your Well-Woman Visit

You and Your Well-Woman Visit

Your insurance covers an annual well-woman visit. But what exactly does that mean?

Your yearly well-woman visit can be either a combination of your annual physical and care specific to you as a woman or a separate appointment for just that care.

Preventive Care at Your Well-Woman Visit

Your plan covers a lot of preventive care and screenings, many of which you’ll get at your yearly physical. But for some of the care, you’ll probably want to schedule a separate well-woman visit with a specialist, like a gynecologist, or even multiple appointments with your doctor and different specialists.

Depending on timing and what your doctor recommends, this care includes:

Screenings & Care
  • Osteoporosis screening – For women over age 60, depending on risk factors
  • Domestic and interpersonal violence screening and counseling
Cancer Screenings & Counseling
  • Breast cancer genetic test counseling (BRCA) – For women at higher risk
  • Breast cancer mammography screenings – Every 1 to 2 years for women over 40
  • Breast cancer chemoprevention counseling – For women at higher risk
  • Cervical cancer screening – For sexually active women
Sexually Transmitted Infection (STI) Screenings
  • Sexually transmitted infections counseling – For sexually active women
  • Chlamydia infection screening – For younger women and other women at higher risk
  • Gonorrhea screening – For all women at higher risk
  • HIV screening and counseling – For sexually active women
  • Human Papillomavirus (HPV) DNA test – Every 3 years for women with normal cytology results who are 30 or older
  • Syphilis screening – For women at increased risk

And if you’re pregnant or may become pregnant, there’s even more preventive care covered for you.

Prepare for Your Visit

Preparing with questions, and answers to your doctor’s questions, can help you make the most of your visit.

Know Your Family History

Talk to your family members, especially your mom, about your family’s history of women’s health issues. For example, as a woman, you’re more likely to get breast cancer if it’s genetic on your mom’s side of the family. So knowing this information can help your doctor keep an eye out for genetic issues you’re at risk for.

Talk to Your Doctor

Prepare for your appointment by knowing any questions or issues you want to talk to your doctor about. Some things you might want to ask include:

  • What immunizations or shots you need, like the HPV vaccine
  • If you should get STI screenings
  • Help getting pregnant or birth control options
  • How to do self-exams to regularly check for breast cancer
  • Mental and social health concerns, like relationship issues or domestic violence questions
  • Specific issues you might be having, like problems with your menstruation or abnormal pain or cramping

Know What’s Covered

Log in to Your Health Alliance or search by your member number to see what preventive care your plan covers.

Or use our general preventive care guidelines and prescription drugs or our Medicare preventive care guidelines to get an idea of what our plans cover.

If you’re not sure what’s covered and what you’ll need a preauthorization for, you can also check your coverage and preauthorization lists at Your Health Alliance.

Now that you’re ready to go to your well-woman visit, log in to Your Health Alliance to find a covered doctor, or start searching for doctors in our network.

Your Preventive Care

Your Yearly Preventive Care and Physical

Getting your yearly physical, where you can get covered preventive care and screenings, helps you be your healthiest. It’s important that you not only know what’s recommended for your age and what you need to stay up to date, but also that you get to the doctor for this each year!

What Happens at Your Physical

Each year, you should schedule a physical with your doctor to focus on your health and wellness. At the appointment, you can:

  • Keep track of your health habits and history
  • Get a physical exam
  • Stay up-to-date with preventive care
  • Get education and counseling and set health goals

Health Habits & History

One of the first things that happens at your annual appointment is a nurse or your doctor will ask you to answer some questions about your health and family history, including questions about:

  • Your medical history
  • Your family history
  • Your sexual health and partners
  • Your eating and exercise habits
  • Your use of alcohol, tobacco, and other drugs
  • Your mental health history, including depression
  • Your relationships and safety

This info can help you in the future. From getting diagnosed to being protected and helping you in an emergency, this information can help save your life.

Physical Exam

At your yearly physical, you can expect your doctors or nurses to:

  • Measure your height and weight
  • Calculate your body mass index (BMI) to check if you’re at a healthy weight
  • Take your blood pressure and temperature

From there, your doctor may give you your regular preventive care screenings and shots or refer you to a specialist for certain screenings, counseling, or care.

Preventive Care

As an adult, certain preventive care and screenings are covered for you, depending on timing and what your doctor recommends.

Immunizations (Shots)

Doses, recommended timing, and need for certain immunizations can vary based on your case:

  • Diphtheria
  • Flu shot
  • Hepatitis A
  • Hepatitis B
  • Herpes Zoster
  • Human Papillomavirus (HPV)
  • Measles
  • Meningococcal
  • Mumps
  • Pertussis
  • Pneumococcal
  • Rubella
  • Tetanus
  • Varicella (Chickenpox)
Condition Screenings & Care
  • Aspirin use – To prevent heart disease for adults of a certain ages
  • Cholesterol screening – For adults of certain ages or at higher risk
  • Blood pressure screening
  • Type 2 diabetes screening – For adults with high blood pressure
  • Colorectal cancer screening – For adults over 50
  • Depression screening
Weight Management
  • Obesity screening and counseling
  • Diet counseling – For adults at higher risk for chronic disease
Alcohol & Tobacco Use
  • Alcohol misuse screening and counseling
  • Tobacco use screening – For all adults and cessation interventions for tobacco users
  • Lung cancer screening – For adults 55 to 80 at high risk for lung cancer because they’re heavy smokers or have quit in the past 15 years
  •  Abdominal aortic aneurysm – A one-time screening for men of certain ages who have ever smoked
Sexually Transmitted Infection (STI) Screenings
  • Sexually transmitted infection (STI) prevention counseling  – For adults at higher risk
  • Hepatitis B screening – For people at high risk, including people from countries with 2% or more Hepatitis B prevalence, and American-born people not vaccinated as infants and with at least one parent born in a region with 8% or more Hepatitis B prevalence
  • Hepatitis C screening – For adults at increased risk and once for everyone born from 1945 to 1965
  • HIV screening – For everyone ages 15 to 65 and other ages at increased risk
  •  Syphilis screening – For adults at higher risk

Women also have some additional covered screenings and benefits. Get more details about this specific preventive care while learning about your well-woman visits.

And learn more about what preventive care the United States Preventive Services Task Force recommends you get and when.

Education, Counseling & Health Goals

Your doctor can help you manage your conditions or diseases and prevent future problems by talking to you about your life and health each year.

Your doctor might have valuable handouts, websites, advice, and information to help you take care of yourself or might want to refer you to a specialist who can help you further.

Your doctor is also the perfect person to help you set goals to maintain or improve your health. From quitting smoking and knowing how to self-check for cancer to changing your diet and exercise for your weight, cholesterol, or blood pressure, your doctor can help you plan to be your healthiest.

Prepare for Your Visit

Preparing yourself with questions to ask and answers to your doctor’s questions can help you make the most of your visit.

Know Your Family History

Your family’s history of health and wellness is an important part of your own health record. Histories of illness and disease can help doctor’s look out for issues that run in families and more.

This family health history tool can help you track your family’s health, so that you’re always organized to talk to your doctor. Not sure about your family history? Filling this out is the perfect time to talk to family members for firsthand details.

Talk to Your Doctor

Prepare for your appointment by knowing any questions or issues you want to talk about ahead of time. Some things you might want to ask:

  • What immunizations or shots you need
  • Your diet and eating healthy food
  • Advice for exercise and getting active
  • Mental health concerns, like depression and anxiety
  • Specific issues you might be having, like sore joints, back pain, migraines, and more

Know What’s Covered

Learn more about your covered immunizations. And log in to Your Health Alliance or search by your member number to see what preventive care your plan covers.

You can use our general preventive care guidelines and prescription drugs or our Medicare preventive care guidelines to get an idea of what our plans cover.

If you’re not sure what’s covered and what you’ll need a preauthorization for, you can check your coverage and preauthorization lists at Your Health Alliance.

Now that you’re ready to go to your annual physical, log in to Your Health Alliance if you need to set a Primary Care Provider (PCP) and find a covered doctor, or start searching for doctors in our network.

Testicular Cancer Awareness Month

Testicular Cancer Awareness Month

It’s Testicular Cancer Awareness Month, which is the leading cancer in men ages 15 to 44.

Raising Cancer Awareness

 

1 out of 270 men will be diagnosed with testicular cancer. It can develop fast and double in size in just 10 to 30 days.

When detected early, it has a survival rate of over 95%. Regular self-exams are the best way to find it early.

Self-Exams to Prevent Testicular Cancer

 

Testicular cancer can elevate your hormones, causing tenderness in your chest. Learn other signs.

Chest Soreness and Other Symptoms

 

Back pain and significant weight loss are some of the signs and symptoms of advanced testicular cancer. See your doctor quickly.

Symptoms of Advanced Testicular Cancer

 

If you’re diagnosed with testicular cancer, there are questions you should ask to find out what comes next.

The Right Questions to Ask Your Doctor

 

Treatment for testicular cancer is much like other cancers. It can include surgery, chemotherapy, and radiation.

Testicular Cancer and Treatment

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In Case of Medical Emergency

Long View: What Is a Medical Emergency?

According to Medicare.gov, a medical emergency is a situation where “[Y]ou believe you have an injury or illness that requires immediate medical attention to prevent a disability or death.”

It seems pretty straightforward, so why are there so many questions around the decision to get treatment at your local emergency room?

An emergency room (ER) provides some of the most sophisticated diagnostic options in a hospital and the most immediate care to patients in crisis.

The list of possible emergencies is endless, so it’s important for you to recognize how serious your injury or illness is and to know the best way to get treatment for it.

Many of us have heard about folks with medical emergencies driving themselves to get treatment or catching a ride with a family member. Please don’t. Driving yourself puts you and others in jeopardy and delays the start of your treatment. Dialing 911 brings you the treatment quickly and gets you to an emergency room faster than a white-knuckle trip across town, dodging traffic lights.

Dr. Frank Friedman, one of our medical directors who specializes in emergency care, said, “A true emergency is one that can’t wait. It is something causing such severe pain or such a risk to life or limb, for oneself or a loved one, that it can’t wait hours, or a day or two, to be seen by one’s own doctor or healthcare provider.”

If it’s not an emergency but you need medical care to keep an illness or injury from getting worse, call your doctor. If your doctor can’t see you right away or the office is closed, urgent care (or convenient care) can help you get treatment quickly.

Over the years, I have heard some interesting and alarming questions from our members. This FAQ can help answer those questions.

Q. I just got one of your policies, and I’m having severe chest pain. Will you cover me for an ER visit?

A. This is one of the most unsettling questions we receive. If you’re experiencing severe chest pain, don’t call your plan, call 911. It’s as simple as that.

Q. Do I have to pay a copay when I get there?

A. No, they should be able to bill you, so there’s no reason to wave your credit card around as they wheel you through the front door. In fact, under federal law, an ER has to evaluate and stabilize you in an emergency medical situation, without regard for your ability to pay.

Q. What if I have special conditions they need to know about?

A. Keep a list of your medications with you. MedicAlert’s medical IDs or the Yellow Dot program can also help you share this information. And many smart phones have features that let you add emergency contacts and medical information. Plan ahead.

Q. What are some examples of when I should go to the ER and when I should go to my doctor or urgent care?

A. Visit the ER for emergencies like chest pain, broken bones, poisoning, shortness of breath, fainting, and seizures. For things like a constant fever, strep throat, sprains, the cold or flu, earaches, or minor infections like pink eye, call your doctor or visit urgent care.

Will you recognize a medical emergency? Probably yes, so trust your judgment, act quickly, and please be careful out there.

Patrick Harness is a community liaison with a long history of experience in health insurance. If you ask him to pick a color, he always chooses orange, and he is known for his inability to parallel park.

Record of Military History

Vantage Point: Take it Easy

In late January, Eagles cofounder and songwriter Glenn Frey passed at only 67 years old. As the radio played lyrics from songs such as “Desperado,” memories flooded back of when I first heard them and where I was during that period of my life.

I remember my parents had the album “Hotel California,” and even though I was too young to understand the lyrics, I played that album at its highest volume, singing “Welcome to the Hotel California, such a lovely place, (such a lovely place,) such a lovely face,” while using the fireplace poker as my electric guitar.

Recently while helping an elderly gentleman in our customer service office, he spotted the picture of my boys in their military uniforms sitting on my desk. The gentleman looked at me with sharp, clear, blue eyes and proudly told me he had served in the U.S. Air Force during the Korean War.

He explained how at the time, America’s fighter jets would flame out when trying to fly as high as the North Korean MiG, so to learn North Korean aviation secrets, the Air Force offered a reward for anyone who could deliver one to them. I sat mesmerized as the man turned young before my eyes, reiterating how he was present the day a North Korean fighter pilot landed the MiG right on their Air Force landing strip.

During the Moses Lake Business Expo, a lovely couple told me they were Health Alliance members. The gentleman lifted both arms to show me his muscles and said, “Don’t I look healthy?” Then he surprised me by asking, “Would you believe I am 90?”

When I think of Glenn Frey, it’s hard to imagine the co-writer of such timeless songs ever being old enough to be on Medicare, and his passing caused a heartache tonight for many.

It is an honor to know my job allows me to help people who contributed in their youth to American military history, truly living life in the fast lane. And it is so inspiring to be able to meet someone 90-years-young who can make me feel like the new kid in town.

For those who may be aging into Medicare and have questions or concerns, take it easy knowing we not only have the knowledge and resources to help you, but we also respect the long run that got you here.

Shannon Sims is a Medicare community liaison for Health Alliance, serving Chelan, Douglas, Grant, and Okanogan counties in Washington. She has four sons and two grandsons. During her time off, she performs as part of a rodeo drill team on her horse, Skeeter.      

 

Your Personal Health Coach

Vantage Point: A Helping Health Hand

Not every coach is as well known as Pete Carrol of the Seattle Seahawks, but Susan DeLong, our nurse case manager and health coach in our Wenatchee office, is key to our team.

She’s smart, caring, a good listener, and a compassionate advocate. You will probably never see her on TV, but in our members’ eyes, her work is just as important and meaningful as any superstar’s.

Managing a health condition can be hard, and a health coach is someone with extensive experience who can be a consistent source of support. There’s so much information that it can be hard to know what’s key. One of the benefits of a Medicare Advantage plan like ours is the free education and support a health coach can provide.

At Health Alliance, a health coach like Susan can give our members:

  • Answers to questions about their conditions
  • Tools and lifestyle skills to minimize the risk of problems
  • Information about self-care skills
  • Free educational materials and resources about managing conditions
  • Support on the phone at their convenience
  • Help keeping them, their provider, and their caregivers connected
  • Help making the most of their healthcare benefits

Health coaches do not replace medical care from a doctor, but instead work with their primary care physician as part of a team to make sure their management plan is working.

Compassionate nurses like Susan also help identify warning signs for possible health problems, and they make sure members have a plan, day or night, to handle those issues if they become serious.

Susan also works hard to troubleshoot these issues before they become serious health problems. For example, she helps members understand the importance of refilling prescriptions and outlines what they should do if their drugs run out too soon.

Susan even partners with community resource agencies, like Meals on Wheels and the Confluence Health Patient Service Department, to help our members overcome barriers to their care. She knows when a member has a hospital stay or ER visit, and she tracks follow-up appointments and makes sure any meds they’re sent home with will work well with their current prescriptions.

But just like famous coaches, a big part of the job is to motivate. Susan empowers our members to take an active part in their health by setting attainable goals, and we value the important role she plays in our team and in lending a helping hand to our members.

Shannon Sims is a Medicare community liaison for Health Alliance, serving Chelan, Douglas, Grant and Okanogan counties in Washington. She has four sons and two grandsons. During her time off, she performs as part of a rodeo drill team on her horse, Skeeter.      

Make a Difference for Cleft and Craniofacial Awareness

Cleft and Craniofacial Awareness and Prevention Month

July is National Cleft and Craniofacial Awareness and Prevention Month. We had more info each day on these issues and how you can help!

Each year, about 4,400 infants in the U.S. are born with a cleft lip or palate. Donate now.

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Clefts are a hole or notch in the lip, palate, or ridge, and they can happen together. They vary in seriousness and treatments. Learn more from the CDC.

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The National Birth Defects Prevention Study (NBDPS) helps learn about prevention for cleft lips and palates. They have found that diabetes, smoking, thyroid disease, and certain medications during pregnancy can increase chances.

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Books like Wonder can help teach your kids about facial differences, which helps with awareness and acceptance of cleft lips and palates.

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Some who adopt get kids dealing with cleft lips or palates, but this Q&A can help you learn more about the issues.

A young baby with a cleft palate looking over the shoulder of her mother

 

Learn how you can make a difference and do cleft lip and palate community outreach with Pathfinder.

Join a family-to-family connection from cleftAdvocate to get help with questions anytime.

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