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| Screenings for your health | ||||
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Breast Cancer Breast cancer Breast self-exam: Screening Benefit: The city’s medical benefits
plans cover an annual well-woman exam for HMO and POS in-network
members. This includes a clinical breast exam, an annual mammogram
and required diagnostic tests for women over 40 or female members
with other risk factors. Arthritis Why the disease occurs is still a mystery. There is no cure for either osteoarthritis or rheumatoid arthritis. Treatment, however, can ease inflammation and pain. If you suspect you or other family members have arthritis, consult your physician immediately. Screening Benefit: Early diagnosis helps you effectively manage your arthritis. Physicians diagnose arthritis based on one or more physical exams and your symptoms. X-rays are used to confirm the diagnosis and determine severity. Charges: HMO members’ copayment is $20 for an office visit. The copayment is $30 for POS in-network and 40 percent after a $500 deductible for POS out-of-network. The Out-of-Area plan is 30 percent after a $350 annual deductible. For the HMO and POS in-network plans, X-rays are included in the office visit cost if performed in a laboratory or doctor’s office Blood pressure Low blood pressure, the abnormal decline in pumping pressure, causes inadequate blood flow to the heart, brain and other vital organs and prohibits normal bodily functions. A doctor or nurse uses a sphygmomanometer, an inflatable rubber arm cuff with a stethoscope and pressure gauge attached to it, to measure blood pressure. Screening Benefit: A 30-second, painless blood pressure check enables your doctor to correct abnormal blood pressure with lifestyle changes and/or prescribed drugs. Charges: Blood pressure is taken during most office
visits, which require a copayment of $20 for HMO, $30 for POS in-network
and 40 percent after a $500 deductible for POS out-of-network. Many
drug stores offer free screenings. Cholesterol High cholesterol is a build-up of fatty deposits in arteries. Continued accumulations cause clots in the arteries and block blood flow to the heart and/or brain. Your level of LDL, or “bad” cholesterol, should be 160 or lower. If you have risk factors for heart disease, it should be no higher than 130. Screening Benefit: RA cholesterol screening will reveal high cholesterol. Many times, it can be reduced by a healthier diet. Charges: Cholesterol blood tests may be taken
on request during any office visit, which requires a copayment of
$20 for HMO, $30 for POS in-network and 40 percent after a $500
deductible for POS out-of-network. Colorectal cancer The fecal occult blood test, double-contrast barium enema, sigmoidoscopy and colonoscopy screen for polyps that may become cancerous and for rectal and colon cancer. Screening Benefit: A cure is more likely when cancer is found early by screening. Charges: Screenings are free for members 50 or older. Members under 50 may qualify if they have specific risk factors. All primary care physician referrals must specify colorectal screening. If the doctor removes polyps or in- flamed tissue, that is outpatient surgery and requires a $200 copayment for HMO members. POS in-network members pay 15 percent after a $400 copayment, and POS out-of-network members pay 40 percent after the annual deductible. The Out-of-Area plan covers 70 percent after the annual deductible. Lung cancer Symptoms include fatigue, a persistent cough that gets worse, shortness of breath, wheezing or hoarseness and loss of appetite or weight. (For more symptoms, see Head off lung cancer, disease.) Doctors use several methods to detect lung cancer including a spiral-computed tomography X-ray, chest X-rays and analysis of the mucus coughed up from the lungs. Screening Benefit: Regular screenings improve the likelihood of detecting small, early lung cancers and a better chance for effective treatment. Charges: HMO and POS in-network plans cover expenses after a $20 copayment for HMO and $30 copayment for POS in-network. POS out-of-network covers 60 percent of expenses after the annual deductible. The Out-of-Area plan covers 70 percent of expenses after the annual deductible.
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