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Item E1BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: July 27, 2015 Division: Employee Services Bulk Item: Yes _ No X Department: Employee Benefits Staff Contact Person/Phone 4. Teresa Aguiar X4458 AGENDA ITEM WORDING: Discussion and approval regarding FYI 6 Monroe County Preventative Care Wellness Program Health screenings for 4 hours of annual leave (excluding Sheriff and Tax Collector) and FY17 Monroe County Preventative Care Wellness Program Health screenings for 4 hours of annual leave (excluding Sheriff and Tax Collector) and/or age appropriate preventative health screenings for S25/month discount off the employee contribution toward health insurance for County Commissioners, Constitutional Officers and employees who participate in the Group Health Plan. ITEM BACKGROUND: Wellness programs promote healthy behavior amongst employees covered by the County Group Health Insurance Plan. The concept is that if the employees annually participate in preventative health care screenings and healthy lifestyles, the long term claim costs will be less and the rising costs of healthcare will not be fully needed if potential health issues are caught earlier than when they become a crisis type of health issue (such as a heart attack or progressive cancer). The County has offered and has continued to offer wellness activities for employee participation such as Lunch & Learns and reimbursements for participating in walk/bike/triathlon events in the community to encourage wellness behavior. We also coordinate annual health fairs for group health plan participants in the Lower, Middle and Upper keys. Typically, at the health fairs, employees can have their Height, Weight, Blood Pressure, Cholesterol, Blood Sugar, and Body Mass Index (BMI) screened, thus yielding any warning signs employees need to see their doctors to ward off any shown risks that could lead to more serious health issues. The proposed 2017 Age Appropriate Preventative Care Wellness Program covers Monroe County BOCC employees, Commissioners, Constitutional Officers and their employees. At the BOCC meeting on August 20, 2014, the BOCC approved the following FY2015 Health Screening Wellness Program. Employees (those covered and not covered by County Health Insurance) were eligible to receive 4 hours of annual leave if they: a. Attended the Health Fairs held in September/October 2014 and obtained: Biometric (height/weight), OR BIood Pressure, Cholesterol: LDL/HDL/Triglycerides, Blood Sugar Level, and Body Mass Index (BMI) b. Visited their personal physician by 12/31/14 and obtained the following screenings and completed the on-line personal health assessment by 2/1/15 with results. Biometric (height/weight), Blood Pressure, Cholesterol: LDL/HDL/Triglycerides, Blood Sugar Level, and Body Mass Index (BMI) Below are the results of the FY2015 Wellness Program. The overall increase in participants was over 50% by the County offering 4 hours of annual leave as an incentive. There were five critical incidents discovered at last year's health fair that typically, represent potential health cost savings at $125,000 per incident (assuming they would have had a heart attack or stroke) over a three year time period. This means the early detection of the critical incidents in 2014 could have potentially saved $625,000 because of the health care costs (see attached report from Florida Blue). LOCATION 2011 onsite 2015 onsite 2014 onsite Key Largo 37 51 65 Marathon 36 60 72 Key West 89 75 129 Sheriff Office 28 0 0 on -Line PHA 11 8 29 Total 201 194 295 Further, According to Florida Blue, "8 out of 10 (80%) high cost members diagnosed with cancer were identified with cancer in advanced stages (metastasized to other organs). Establishing a relationship with a primary care provider and undergoing appropriate wellness screenings provide the member the opportunity to have a discussion related to prevention opportunities with a physician and can lead to early identification of cancer, increased treatment opportunities as well as increased survival rates". 2016 RECOMMENDED WELLNESS PROGRAM: It is recommended that we continue with the Preventative Care Wellness Program/Health Screenings for 201512016: Employees (those covered and not covered by County Health Insurance) will be required to complete either of the items listed below to receive 4 hours of annual leave to be credited to their leave bank by 3/31/16: • Attend the Health Fairs scheduled for 2015 and participate in: a. Biometric (height/weight) b. Blood Pressure c. Cholesterol: LDL/HDL/Triglycerides d. Blood Sugar Level e. Body Mass Index (BMI) OR • Visit their personal physician and obtain the following screenings (on or between the dates of 1/1115 to 12/31/15) and complete the on-line personal health assessment by 2/1/16 with results. a. Biometric (height/weight) b. Blood Pressure c. Cholesterol: LDL/HDL/Triglycerides d. Blood Sugar Level e. Body Mass Index (BMI) 2017 RECOMMENDED WELLNESS PROGRAM: ➢ It is recommended that we continue the program implemented in 2015 for participation in the health fair for 4 hours of annual leave and enhance the wellness program with an Age Appropriate Health Screenings (see attached form for 2016/2017) as follows: Eligible employees are those who are covered by the County's Health Insurance. They will receive a $25 per month incentive to be taken off their monthly insurance premium and 4 hours of annual leave. If 200 employees participate the cost to the County would be approximately $45,000 in lost employee contributions. Those who are not covered by the County's Health Insurance may still attend the health fairs, etc. but receive no monetary incentive. • Attend the Fairs scheduled for 2016 and participate in: a. Biometric (height/weight) b. Blood Pressure c. CholesteroI: LDUHDUTriglycerides d. Blood Sugar Level e. Body Mass Index (BMI) AND • Visit doctor between the dates of I/1/16 to 10/1/16 for an annual wellness exam and required screenings based on age and doctor determination (see attached) of need: -Mammogram — annual after age 40; -Pap Test — Woman age 21-65 every 3 years or women age 30-65 Pap Test/HPV combined every 5 years; Age 65+ discuss with doctor; -Colorectal Cancer screening — every 10 years ages 50-75; -Abdominal Aortic Aneurysm Check — One-time men ages 65-75 who ever smoked; -Bone Mineral Density Screening — women beginning 65+ and in younger women who have increased risk; -Prostate Cancer Screening — Discuss with doctor, -Skin Cancer Screening — Discuss with doctor; • Submit Health Care Preventative Care — Assessment Acknowledgement Form signed by doctor along with proof OR of visit(s) to the Employee Benefits Office by October 15, 2016; and • Attest to being a non -tobacco user. Visit physician to obtain screenings and blood test on or between the dates of ]/1/] 6 to 10/1/16 a. Biometric (height/weight) b. Blood Pressure c. Cholesterol: LDL/HDL/Triglycerides d. Blood Sugar Level e. Body Mass Index (BMI) • Complete online Personal Health Assessment by February 1, 2017 AND • Visit doctor between the dates of 1/l/16 to 10/1/I6 for an annual wellness exam and required screenings based on age and doctor determination (see attached) of need: -Mammogram — annual after age 40; -Pap Test— Woman age 21-65 every 3 years or women age 30-65 Pap Test/HPV combined every 5 years; Age 65+ discuss with doctor; -Colorectal Cancer screening — every 10 years ages 50-75; -Abdominal Aortic Aneurysm Check — One-time men ages 65-75 who ever smoked; -Bone Mineral Density Screening —women beginning 65+ and in younger women who have increased risk; -Prostate Cancer Screening — Discuss with doctor, -Skin Cancer Screening — Discuss with doctor, • Submit Health Care Preventative Care — Assessment Acknowledgement Form signed by doctor along with proof of visit(s) to the Employee Benefits Office by October 15, 2016; and • Attest to being a non -tobacco user. It is believed that this program will continue to help encourage sustained improvement in healthy behaviors. Early detection and treatment means that there is a greater chance that we will see moderation in the County's health care costs. The fact is that health care costs are going to continue to go up no matter what we do — Wellness programs help to mitigate those increases. PREVIOUS RELEVANT BOCC ACTION: N/A CONTRACT/AGREEMENT CHANGES: N/A STAFF RECOMMENDATIONS: FYI 6: Continue implementing Monroe County Preventative Care Wellness (Health Screenings for 4 additional hours off for FYI 6) FY17: Beginning 111116 through 10/1/16 implement Monroe County Preventative Care Wellness Program with Age Appropriate Preventative Health Screenings for $25/month discount on employee contribution to health insurance and 4 hours of annual leave for those who participate in the regular health screenings to become effective 1/1/17. TOTAL COST FY16: $0 FY17:$45,000 foregone employee contributions (assuming 200 participants) FY17: $50,000 for additional expense to fund because of Preventive screenings* $95,000 total cost -- real dollars short term annual Potential Estimated Savings: Estimated Savings based on 3:1 investment ratio industry standard: $150,000 This number includes lower absenteeism and presentism. A more conservative estimate to FY18 savings with these assumptions is: FY18 Savings ^$150 006 *Female participation estimated at twice the participation as males INDIRECT COST: BUDGETED: Yes No DIFFERENTIAL OF LOCAL PREFERENCE: COST TO COUNTY: N/A SOURCE OF FUNDS: REVENUE PRODUCING: Yes — No X AMOUNT PER MONTH Year APPROVED BY: County Atty _ OMB/Purchasing Risk Management DOCUMENTATION: Included X Not Required DISPOSITION: AGENDA ITEM # V I ;Ith Screening Executive Summary Report for. Monroe County BOCC la a trade naRw .4 Btu* Cross and blue Shield of Florida, Inc., �sen of the. Blue Cross and Blue ShIsid Association. F&P4& Blue $(V .356 EXECUTIVE SUMMARY Monroe County BOCC TOP RISK AREAS The top four at -risk areas for your organization areas follows. Percentages are based on the number of people who ranked "moderate" or "high risk" in each area. Diabetes 85% 252 Nutrition 72% 212 Blood ressure 1 72% 208 BMI 69% 204 2` 2014 Participation Eligible Screening Population 1,615 Participation 295 (18%) Flors4da Blue 11111119 tM pawn of Mahe O 2014 CRITICAL VALUES & Employers Challenge Blood Pressure 5 Blood Glucose 1 Both 0 Total CV's 6 *blood pressure at or above 160/100 and/or blood glucose at or above 300 mg/d (those diagnosed with Diabetes) and at or above 200 mg/d (those not previously diagnosed) Wellness Scores 2012: 72 (200 participants) 2013: 74 (186 Participants) 2014: 74 (295 Participants) •A score below 80 indicates ar elevated likelihood that individuals will develop certain medical conditions Health Care Costs (25%): • Medical Care • Pharmacy 'Savings related to avoiding Heart Attack or Stroke is $125,000 average per incident over 3 years. Productivity Costs (75%): • Absenteeism= 0.2 x annual health care costs • Presenteeism=1.8 x annual health care costs • Workers Compensation • Disability • Safety • Employee Turnover St Recruitment SUMMARY PARTICIPATION 2014 I013 Eligible Screening Population 1,615 1,632 PHA Participation 295 186 Paper PHA 266 186 Online PHA 29 8 Blometric Screening Participation 266 194 PHA Participation vs, Eligible 28% 12% Florida Blue Member PHA Participants' 292 190 Members vs. PHA Participation 95% 100% Number of Critical Values Blood Pressure Blood Glucose Both Critical Values vs. Attendance Florida Blue Statewide Average Members vs. Nonmembers Members Non members Members Enrolled in Next Steps TOP RISK AREAS The top four at -risk areas for your organization are as follows. Percentages are based on the number of people who ranked "borderline" or "high risk" in each area. RlskArea Pemritase Number Responses Diabetes 85% 251 295 Nutrition 72% 212 294 Blood Pressure 72% 208 290 BMI 69% 204 295 CRITICAL VALUES 2014 2013 6 5 5 4 1 1 0 0 2.0% 2.7% 2.7% 2.7% 6 5 0 0 6 3 • The number of Florida blue member parunpants is determined by the number of people providing contract IN that match the member listing on ale I The denominator for each measure In this report vanes Wiled on the number of participants that complete the questions (subject to age and gender, where appropriate) The rumeritor for each measure shows IW number of panic pants in each measurement category, based on their results Values shown may not equal 100%die to round,". 3 CRITICAL VALUE REPORT All participants identified with blood pressure at or above 160/100 and/or blood glucose at or above 300 mg/d (those diagnosed with diabetes) and at or above 200 mg/d (those not previously diagnosed) are referred to a Florida Blue nurse for assistance and confidential counseling. Those participants identified with critical values who are Florida Blue members are sent a follow-up letter after the screening Informing them of their own responsibility to urgently follow up with a doctor. Florida Blue members are also offered ongoing health coaching. Total Critical Values Became Aware from Assessment Diagnosed Prior to Assessment 6 50% 50% Participants were identified as having a blood of critical value participants became aware of critical value participants were already pressure or blood glucose value requiring they had a critical health condition from the diagnosed with the identified condition prior Immediate medical attention. health screening. to the heahh screening. Follow-up Letters OQ% Blood Pressure 2 Blood Pressure 3 Glucose 1 Glucose 0 All members receive a follow-up letter that Both 0 Both 0 provides additional resources and available programs. Total 3 Total 3 The denominator for each moo can in this sport canes based on the number of part K pants that comp I* to the quests s Isublect to age and render, where appropriate). ?he nome!uor fe• ea-h mra sore show. the numbet of panicipana in each measurement category, bated an their results Varws shown may not egwl 100%doe to rounding COMPARISON REPORT MONROE COUNTY SOCC WELLNESS PARTICIPATION DEMOGRAPHICS SCORE Sazft- Screening Site She Score Total Group Pmettt Percent Majority Percent Majority Aft)""Pereertt Date Participants Percent Male Percale Age Group Key West 9/28/2014 74 119 44% 33% 67% 50 59 36% White 66% Key Largo 9/19/2014 73 6S 22% 54% 46% 50 59 37% White 63% Marathon 10/22/2014 76 72 24% 43% 57% 50 59 35% White 93% Online PHA 2014• 10/23/2014 - 2/1/2015 75 29 10% 24% 76% 50 59 48% White 76% 2015 Overall Snore Told % Eligible Percent Percent Majority Percent �joft Percent - Attended Male Female Age Group Eftlelty 2014 Overall 74 295 29% 39% 61% 50 - 59 37% White 71% 2013 Overall 74 186 12% 37% 63% 50 - 59 30% White 70% 2012 Overall 72 200 12% 35% 66% 40 - 49 38% White 67% The ptaentage thown in all -At Risk' columns In this comparison report Includes thaw who ranked'border4ne' and 'high r sk' The denominator for each measure in this report varies bawd on the number of participants that cmnplete the questions (subject to age and Render, where appropt ata) The numerator for each measure shows the number of participants In each measurement category, bated on thec results. Vs uet shown may not equal 100%due to rounding OVERVIEW OF RISK FACTORS Risk Factor Score Ideal Borderline High Risk 2014 1 2013 2014 1 2013 2014 1 2013 2014 2013 BMI Blood Pressure 64 67 65 74 31% (91) 28% (82) 35% (65) 43% (79) 33% (96) 61% (177) 28% (51) 51% 194) 37% (108) 11% (31) 37% (69) 6% (12) Total Cholesterol 78 75 66% (193) 61% (113) 27% (78) 26% 148) 7% (20) 13% (23) HDL Cholesterol 68 65~ 44% (129) 40% (74) 32% (92) 32% 159) 24% (69) 28% (51) awliesterol Ratio 86 85 72% (211) 70% (129) 26% (76) 28% (51) 2% (S) 2% (4) LDLCholesterol 86 0 83% (22-2) WO) 14% (37) 0% (0) 3% (8) 0% (0) Trlglycerides 77 0 69% 1195) 0% (0► 14% (40) 0% (0) 17% (47) 0% (0) Diabetes Risk 53 56 15% (44) 16% (30) 53% (155) 58% (308) 33% (96) 26% (48) Blood Sugar 88 87 75% (216) 76% (139) 20% (58) 17% (32) S% (14) 7% (13) HbAic 58 0 38% (3► 0% (0) 38% (3) 0% (0) 25% (2) 0% (0) Nutrftlon 64 54 28% (82) 19% (36) 55% (163) 32% (59) 17% 149) 49% (91) Physical Activity Stress Depression Tobacco 79 75 85 87 83 68 82 86 65% (192) _ 63% (186) 98% (260) 88% (260) 76% 1141) 53% (98) 79% (147) 84% (156) 18% (53) 30%(88) ^11% 132) 5% (15)~r� 13% (25) 25% (46) 17% (32) 8% (14) 17% 150) 7% (21) 1% (3) 7% (201 11% (20) 22% 141) 4% (7) 9% (16) Alcohol 82 81 80% (236) 76% (141) 18% (53) 22% (41) 2% (6) 2% (4) Vehicle Safety 94 94 97% (286) 9S% (177) 1% (4) 4% 17} 1% (4) 1% (2) Risk Factor I Yes I No 20U 2013 2M4 OMP 2M3=Pw Testicular Exam (Men) 57% (66) 50% (34) 43% (50) 50% (34) Pap Smear (Women 21+) 83% (249) 86% (101) 17% (30) 14% (17) Mammmogram (Women 40+) 7396 (104) 69% 162) 27% (39) 31% (281 Colonscopy (Age 50+) 61% (97) 53% (47) 39% (62) 47% (42) Annual Wellness Exam (All) 88% (261) 84% (157) 12% (34) 16% (29) Annual Flu Shot (A8) 43% (126) 35% (6S) 57% (169) 65% (121) The derwminalor for each measure in this report varies based on the number of participants that ca pleta the questions (subject to are and render, where appopriataj. The numerator for each nwasure shows the number of panlcipwai in each measurement category, based on their results Values shown may not equal IM due to rou ridmr 6 County of Monroe The Florida Keys Employee Health Preventative Care - Assessment Acknowledgment Form Effective January 1, 2017 Services provided between: 1/1/16 through 10/1/16 Employee Name: Age: (Please Print) Male: Female: Position: Physician Name: (Please Print) (Please Print) Department: (Please Print) Completion Date: Physician Acknowledgement: My signature below indicates that the following tests, assessments, clinicals indicated, pertain to the employee identified above, have been measured, if I deemed appropriate . The results of which have been reviewed with the employee in accordance with established treatment protocols. Biometrics Information: Check if completed Recommended tests (Not required) if applicable at Ph siclan's discretion: Wellness checkup/ Physical Vitamin D The below can be done at the County's annual health fair or with your personal physician: Vitamin B Height/Weight CBC Blood Pressure: Systolic Diastolic CMP Cholesterol : LDL HDL Tri l cerides TSH Blood Sugar Level Bilirubin screening Body Mass Index BMI HBAlc If diagnosed diabetic Required Preventative Screenings discussed with Physician. If screening is recommended and done at a different office (such as a hospital), proof of procedure/visit with name of patient and date of procedure must be attached to this form. Mammogram: Annually at ages 40+ OR Not required at this time (age, screening given within past year, etc.) Pap Test: Women age 21-65 every 3 years or women age 30-65 Pap TesUHPV combined every 5 years; Ages 65+ discuss with doctor OR Not required at this time Screening for Colorectal Cancer: Ages 55-75 with either a colonoscopy, fecal occult blood test or sigmoidoscopy OR Not required at this time Pagel of 2 Abdominal Aortic Aneurysm Check: One-time men ages 65-75 who have ever smoked OR Not required at this time Bone Mineral Density Screening and prescribed medication for osteoporosis: Women beginning 65+ and in younger women who have increased risk OR Not required at this time Prostate Cancer Screening: Discuss with doctor Skin Cancer Screening: Discuss with doctor` Doctor: I have given the patient the results of these tests and the employee has been counseled on the results and necessary follow up to prevent further health issues: "4W. Physician Signature: Date: Physician Address:�� Physician Phone #: Please give patient a copy of this form, completed biphysician and mail completed, signed form to: Monroe County Employee Benefits Office Gato Building, 2"d Floor, Room 268 „f 1100 Simonton Street Key West, FL 33040; EMPLOYEE SIGN BELOW: le I hereby certify that I do not currently use or have used tobacco products five or more times in the previous three months. Tobacco products are defined as cigarettes, cigars, pipe tobacco, chewing tobacco, snuff, dip, electronic or e-cigarettes that contain nicotine or any other product that contains tobacco or nicotine. I further understand that I may be subject to testing to verify non-use of tobacco products. A refusal to submit to a test is considered "positive" for tobacco use. Employee Name Employee Signature Date Submitted to County on: Date Received by Employee Services Employee Name/Signature: Date: Page 2 of 2 Adult (age 19+) Preventive Schedule Be sure to verify your benefits for preventive services. GuideRoutine Health Physical Examination and Routine Blood Work Annually DieUPhysical Activity Counseling Annually Dental Exam Once or twice a year Mk—Aserritesmay not bemveredbyyour mediWbenefits plan- Check your plan docurin s.) Vision Exam Discuss with your doctor(lhesesmvrcesmay not bemvemdbyyour medical benefits plin. aiedcyourplandoommits.) Recommended, Diagnostic- One-time screening for men ages 65 to 75 who have ever smoked Abdominal Aortic Aneurysm Check Bone Mineral Density Screening & prescribed medication for Osteoporosis Women beginning at age 65 or older; and in younger women who have an increased risk Cholesterol Screening Ages 35+: All Men: Annually and Ages 20+: Men & Women at increased risk: Annually Colorectal Cancer Screening Ages 50.15; With either a colonoscopy, fecal occult blood test or sigmoidoscopy Mammogram _ Annually at ages 40+ (per the American Cancer Society) Pap Test Women age 21-65 should have Pap Test every 3 years or women age 30.65 should have Pap Test/HPV combined testing every 5 years; Ages 65+: Discuss with your doctor. HIV and other Sexually Transmitted Infections (STIs) Screening and Counseling As indicated by history and/or symptoms. Discuss with your doctor behavioral risks Ages 55.80; 30 pack smoker history,current smoker/quit within past 15 years Lung Cancer Screening Prostate Cancer Screening Discuss with your doctor Skin Cancer Screening Discuss with your doctor Fall Risk/Unintentional Injury Discuss exercise, home safety and vitamin 0 supplementation with your doctor Screen/Counseling Depression, Tobacco, Alcohol, Pregnancy, Substance Abuse and Injury/Domestic Violence Prevention Every visit, or as indicated by your doctor Advance Directives Annually (Routine.. . Tetanus, Diphtheria, Pertussis (Td/fdap) Ages 19+: Tdap vaccine once, then a Td booster every 10 years" FLU (Influenza) Annually during flu season Pneumococcal' PCV13 and PPSV23 Ages 19.64: if risk factors are present; Ages 65+: 1 dose (per CDq; Ages 50+:1 dose (Florida Blue Benefits") Shingles (Zoster)` Ages 60+:1 dose (per CDq; Ages 50+:1 dose (Florida Blue Benefits") Haemophilus InfluenzaeType b (HIB) Hepatitis A, Hepatitis B, Meningococcal Ages 19+: if risk factors are present Human Papillomavirus (HPV), Measles/Mumps/Rubella (MMR), Varicella (Chickenpox) & Hepatitis C (HCV) Infection Screening Physician recommendation based on past immunization or medical history * Some immunizations are contraindicated for certain conditions, discuss with your doctor. `• If you are pregnant, talk to you doctor about getting a Map vaccine during 3rd trimester of every pregnancy to protect your baby from pertussis (whopping cough). Florida Blue Pharmacy benefits cover Shingles (Zostavax and Pneumonia (Pneumovax) vaccine under Preventive Service benefit when services are rendered by an in -network pharmacy which administers these vaccines. Florid, Blue 0`1I In the pursuit of health Live a Healthy Lifestyle • Get your annual wellness exam to review your overall health plan and keep follow-up msits with your doctor. • Find out if you are at risk for health conditions such as diabetes. • Get your vaccines, preventive screenings and labs. • Human f apillomavirus (HPV) vaccine 3 dose series is recommended for men and women ages 19 through 26 years if not previously vaccinated prior to age 13 • Talk with your doctor about the medications and over-the- counter/vitamins you are taking to reduce side effects and interactions. • Get a Flu Vaccine every year to prevent illness and related hospitalizations. We're here to help: Call Customer Service 1-800-FLA-BLUE (1-800-352-2583) TTY/TDD Call 711 Care Consultant Team 1-888-476-2227 24-Hour Nursetine 1-877-789-2583 Click Visit FloridaBlue.com Visit a Florida Blue Center Go to Florida Ell ueCenters.com for locations or call 1-877-352-5830 Sources: These guidelines are recommendations from the organizations listed below and were not developed by Florida Blue www ahrq gov www cdc gov 82531R 1014 Women (age 65) Preventive BiueMedicareAdvantage Plans. Physical Examination and Routine Blood Work Diet/Physical Activity Counseling Vision Exam, Glaucoma Screening, and Dental Exam Lung Cancer Screening. Bone Mineral DensityScreening and prescribed medication for Osteoporosis Diabetic Screening - Blood sugar, Hemoglobin AlC, LDL Cholesterol, Retinal Eye Exam, Kidney function and Blood Pressure Colorectal Cancer Screening* Mammogram PapTest/Pelvic Exam HIVand other SexuallyTransr (STls) Screening & Counseling Cholesterol Screening Skin Cancer Screening. Early detection of cutaneous melanoma, basal cell cancer, or squamous cell skin cancer in the adult general population. Hearing Test Screen/Counseling:Depression,Obesity, Tobacco, Alcohol & Substance Abuse Fall Risk/Unintentional Injury/Domestic Violence Prevention/Urinary Problems Medication List (including over-the-counter & vitamins) for potential interactions Advance Directives Tetanus, Diphtheria, Pertussis (Td/Tdap) FLU (Influenza) Pneumococcal - PCV13 and PPSV23 Shingles (Zoster) Hepatitis B, Hepatitis C Virus (HCV) Infection Screening and Vadcella (Chickenpox) Annually Annually Ages 55-80; 30 pack smoker history,currentsmoker/quit within past 15 years Women beginning at age 65 or older, and in younger women who have an increased risk Annually Ages 50-75; Either a colonoscopy, fecal occult blood test or sig Annually until age 75; After age 75, discuss with your doctor 65+: Discuss with your doctor Annually Once every 5 years; more frequently if at risk Discuss with your doctor Discuss with your doctor Every visit, or as indicated by your doctor y visit, or as indicated by your doctor Every visit, or as indicated by your doctor Annually Tdap vaccine once, then a Td booster every 10 years Annu Ages 65+:1 dose; Discuss with your doctor es 60+:1 dose Discuss with your doctor Flo^4& Blue ! In the pursuit of heaFth' Take the time to talk with your doctor to develop a plan to take control of your health. Be sure to get your preventive screenings and flu vaccine. *Florida Blue plans cover Routine Preventive Colonoscopy. Refer to Prevention & Wellness Benefits. These guidelines are recommendations by the organizations listed below and were not developed by Florid Blue. Sources: www.ahrq.gov www.medicare.gov www.cdc.gov Y0011 825331014 C:10/2014 Men (age 65) Preventive Schedule Be sure to verify your benefits for preventive services. Certain preventive services are not covered by Original Medicare or BlueMediare Advantage Plans. FCaP1;5&4& B&W, Routine Guide Physical Examination and Routine Blood Work Annually Diet/Physical Activity Counseling Annually Vision Exam, Glaucoma Screening, & Dental Exam Annually Recommended Diagnostic Abdominal Aortic Aneurysm (AAA) Check _ One-time screening for men ages 65 to 75 who have ever smoked or have a family history of AAA** Lung cancer screening is a recommendation by the United Task Force. Ages 55-80; 30 pack smoker historycurrent smoker/ quitwithin past 15 years Diabetic Screening - Blood sugar, Hemoglobin Al C, LDLCholesterol, Retinal Eye Exam, Kidney Function and Blood Pressure Annually Colorectal Cancer Screening* Ages 50-75; Either a colonoscopy, fecal occult blood test or sigmoidoscopy HIV and other Sexually Transmitted Infections (STIs) Screening & Counseling Annually Once every 5 years; more frequently if at risk Cholesterol Screening Prostate Cancer Screening Skin Cancer Screening. Early detection of cutaneous melanoma, basal cell cancer, or squamous cell skin cancer in the adult general population. Discuss with your doctor Discuss with your doctor Hearing Test Guidance Screen/Counseling: Depression, Obesity, Tobacco, Alcohol and Substance Abuse Discuss with your doctor Every visit, or as indicated by your doctor Fall Risk/UnintentionalInjury/Domestic Violence Prevention/Uri nary Problems Every visit, or as indicated by your doctor Mediation List (including over-the-counter & vitamins) for potential interactions Every visit, or as indicated by your doctor Advance Directives Immunizations (Routine Recommendations) Tetanus, Diphtheria, Pertussis (Td/Tdap) Annually Tdap vaccine once, then a Td booster every 10 years FLU (Influenza) Annually Pneumococcal - PCV13 and PPSV23 Ages 65+:1 dose; Discuss with your doctor Shingles (Zoster) Ages 60+:1 dose Hepatitis B, Hepatitis CVirus (HCV) Infection Screening anclVaricella (Chickenpox) Discuss with your doctor In the pursuit of health' We're here to help: Call Member Services 1-800-926-6565 CM dial 1-800-955-8770) 8:00 a.m. — 8:00 p.m. local time, seven days a week from October 1 - February 14, except for Thanksgiving Day and Christmas Day. However, from February 15 - September 30, you will have to leave a message on Saturdays, Sundays and Federal holidays. Care Consultant Team 1-888-476-2227 24-Hour Nurseline 1-877-789-2583 ClickVisit Blue M ed icareF L.com Visit a Florida Blue Center Find a location near you at Florida BlueCenters.com or call 1-877-352-5830 Looking for Medicare coverage? Call 1-877-465-1125 *Florida Blue plans cover Routine Preventive Colonoscopy. Refer to Prevention & Wellness Benefits. **Medicare will pay for a one-time preventive ultrasound screening for men who are at -risk. Florida Blue is an Independent licensee of the Blue Cross and Blue Shield Association. Florida Blue is a PPO and RPPO Plan with a Medicare contrail Florida Blue HMO is an HMO Plan with a Medicare contract Enrollment in Florida Blue or Florida Blue HMO depends on contract renewal. 825331014