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Adult care

Screenings and chronic care management

Early prostate cancer usually doesn’t cause symptoms, regular screenings can be important. Screenings for prostate cancer include a digital rectal exam and a blood test called a prostate-specific antigen (PSA) test. While the PSA test can’t tell if you have prostate cancer, it can show an elevated PSA level and indicate the need for a biopsy to check for cancer. Anyone with a prostate can get prostate cancer. But the risk is higher if you:
  • Are age 50 or older
  • Are African American
  • Have a father, brother, or son who had prostate cancer
Talk with your doctor, together you can decide if /when a screening is right for you.

1American Cancer Society. Prostate cancer risk factors. June 9, 2020. Accessed April 2022.

Screening mammograms are considered the international gold standard for detecting breast cancer early. Mammograms can usually find lumps two or three years before they are felt.

Finding breast cancer early reduces your risk of dying from the disease by 25-30% or more. For women with no history of cancer, U.S. screening guidelines recommend they start getting mammograms when they turn 40 or 50. They should also continue getting one every one or two years. This routine continues until they turn about 75 years of age or if they have limited life expectancy. Those who choose to get a mammogram every two years instead of annually might face a greater risk of being diagnosed with larger, later-stage breast tumors.

Talk to your doctor about when to start breast cancer screening.

If you’re a man who has a high risk of breast cancer because of personal or family history, your ethnicity, or a genetic mutation, it makes sense to talk to your doctor. While clinical guidelines don’t recommend regular mammograms for high-risk men at this time, you and your doctor can work to develop a screening plan that makes sense for you and your unique situation.

It’s also important to talk to your doctor right away about any changes in your breasts, including:

  • Nipple pain
  • Inverted nipple
  • Nipple discharge
  • Sores on the nipple and/or areola area
  • Enlarged lymph nodes under the arm

Because many men don’t consider the possibility that they may develop breast cancer, they may wait a year or longer to talk to their doctor after noticing a breast symptom. Waiting can result in men having a higher risk of dying from breast cancer, even though the disease is much more common in women.

For more information, visit the pages on Male Breast Cancer.

Uscher, J. (2022, November 18). Male Breast Cancer .

The benefits of regular health screenings and check-ups include:

  • Peace of mind
  • Identifying and preventing issues early on
  • Getting regular tests run
  • Building a relationship with your doctor
  • Cancer prevention (gynecology-specific)

Catching health issues early before they get too bad can save your life. Call your doctor to schedule your screening or call us to help you at 1800-410-7778 (TTY:711).

Cervical cancer is one of the most preventable cancers. Visit the US Preventive Services website for more information.

Menopause and your health

You can start to experience menopause generally at age 45 and older. Some health conditions are linked to changes in hormone levels such as osteoporosis and heart disease as indicated in the information found at


A bone density test can detect early signs of osteoporosis. Check with your provider and plan for screening procedures. They can help maintain or improve your bone health.

Heart disease

Heart disease is a leading cause of death in the U.S. It’s the number one cause for women. Heart disease is also linked to uncontrolled high blood pressure.

It is recommended to start regular screenings at age 45 and more often for individuals with a personal or family history of colorectal cancer or polyps, inflammatory bowel disease or previous abdominal or pelvic radiation treatment. Talk to your doctor about test options.

Have your doctor check your skin once a year during your annual exam, mentioning any suspicious skin growths or changes.

Know the ABCDEs of early detection:

  • Asymmetry: One half doesn’t match the other half. 
  • Border irregularity: The edges are ragged, notched, or blurred. 
  • Color: Pigmentation is not uniform. Shades of tan, brown, and black are present. Dashes of red, white, and blue add to the mottled appearance.
  • Diameter: Size of the mole is greater than 6 mm (0.25 in.), or about the size of a pencil eraser. 
  • Evolution: Change in the size, shape, symptoms (such as itching or tenderness), surface (especially bleeding), or color. 

Chronic kidney disease (CKD) is categorized by Stages 1 – 5, depending on how much kidney function is present. Stage 1 is mild kidney damage, progressing to Stage 5 which is kidney failure. If you have risk factors for CKD, or any of the symptoms, talk to your doctor about your kidney health and your personal risk for developing CKD:

Main risk factors for kidney disease

  • Diabetes
  • High blood pressure
  • Heart disease
  • Family history of kidney disease

Symptoms of chronic kidney disease (CKD)

  • Weight loss or poor appetite
  • Frequent urination
  • Swollen ankles, feet or hands
  • Difficulty sleeping
  • Itchy Skin
  • Fatigue
  • Shortness of breath

Ask your doctor about getting screened for lung cancer if all of these apply to you:​

  • You are age 55 to 80.
  • You have a history of heavy smoking for 20+ years.
  • You smoke now, or you quit within the last 15years.

We may cover urine drug testing and screening. Coverage is applied when tests/screenings are conducted for medical purposes related to the evaluation of patients being treated with controlled substances for non-cancer-related chronic pain. These requirements don’t apply when urine drug testing or screening is performed:

  • As part of an emergency room or urgent care center visit
  • During an observation or inpatient hospital stay

Drug testing is defined as either presumptive (qualitative) or definitive (quantitative). A presumptive test confirms if a substance (analyte) is present in the specimen. A definitive test measures how much (the quantity) of an analyte is present.

Presumptive (qualitative) testing

For presumptive drug testing, Aetna® allows one encounter per day up to eight (8) encounters per 12-month period. These are applicable codes for the presumptive drug tests:

  • 80305       
  • 80306     
  • 80307

Definitive (quantitative) testing

Definitive testing is only covered if the presumptive testing indicates a positive result for the drug. Aetna allows one encounter per day up to eight (8) encounters per 12 month period. These are the applicable codes for the definitive drug tests:

  • G0480     
  • G0481     
  • G0482     
  • G0483     
  • 0051U   
  • 0054U     
  • G0659

If you have any questions about this policy, please contact us at 1-800-410-7778 (TTY: 711). We’re available 24 hours a day, 7 days a week, except certain holidays.

CPT® is a registered trademark of the American Medical Association. 2022 All rights reserved.

If your ages 18 to 79 it’s recommended you get a blood test for hepatitis C at least once. Talk to your doctor about getting tested for hepatitis C.

Most low back pain will improve with rest, modified activity and over-the-counter pain medicine as needed.​ Consult with your doctor for the best treatment for you. 

How to keep your muscles healthy

One of the most important ways to protect and support your muscles is to stretch regularly. Doing so allows you to move more easily and freely, whether you’re walking, running, biking or playing a sport.

How stretching helps

Regular stretching can improve your flexibility, which in turn can:

  • Decrease cramping and muscle soreness
  • Help your joints move through their full range of motion
  • Enhance your performance in physical activities

Stretch it out

Stretching isn’t just a warm-up or cool-down exercise. It can be done anytime and anywhere.

Before and after exercise

Stretching helps prepare your body for exercise and helps the recovery process. It can also help improve your joint range of motion as well as reduce stress.

Anytime, anywhere.

Try these simple leg stretches if you can

Front thigh stretch

  1. Stand next to a wall or use a chair for support. Make sure your feet are shoulder-width apart.
  2. Bend one knee so that your foot goes up toward your buttocks.
  3. Grab your ankle and pull it toward your buttocks as far as you can.
  4. Hold the stretch for 15–30 seconds.

Calf stretch

  1. Stand and place your hands on a wall. Move one foot back as far as you can comfortably.
  2. Your toes should be facing forward, heels flat, with a bend in your knees.
  3. Lean into the stretch. You should feel the stretch in your back leg.
  4. Hold the stretch for 15–30 seconds. Repeat 2–4 times for each leg.

Talk to your doctor about safe ways you can stretch and help keep your muscles healthy.

Sexually transmitted infection, or STI testing can help find problems early so that treatment can begin quickly to prevent complications and further spread. Speak to your doctor about your need for your personal risk assessment as STD testing will vary.

Know your numbers

CategorySystolic MMHG (Upper Number)Diastolic MMHG (Lower Number)
NormalLess than 120Less than 80
Elevated120-129Less than 80
Hypertension Stage 1130-13980-89
Hypertension Stage 2140 or higher90 or higher
  • The systolic number shows how hard the blood pushes when the heart is pumping
  • The diastolic number shows how hard the blood pushes between heartbeats, when the heart is at rest

Unmonitored blood pressure may cause damage to your blood vessels which increases your risk for heart disease, stroke, vision loss and kidney problems.

Know your numbers

Cholesterol is carried through the blood stream by two types of proteins called lipoproteins.

  • Low-density lipoprotein, or LDL – often called “bad” cholesterol
    • Too much of it in the blood builds-up on the artery walls as plaque, blocking the arteries and reducing blood flow to the heart and other organs.
  • High-density lipoprotein or HDL – also known as “good” cholesterol
    • HDL grabs hold of the “bad” LDL cholesterol and carries it back to the liver where it’s flushed from the body.

There are different ways to lower your cholesterol:

  • Diet – eat less fatty, sugary, high cholesterol foods.
  • Exercise – helps maintain heart health and prevent or tackle obesity.
  • Medications – there are several types of cholesterol lowering medications, statins can also reduce your risk for heart attack and stroke.
  • Schedule an in person or telehealth visit with your doctor to discuss statin medications and side effects.  
  • Take advantage of your benefits by speaking to a Registered Dietician with the Aetna In Touch Care℠ program.
  • Visit the American Heart Association website and use their calculator to learn about your risks for heart disease, heart attack and stroke.

Know your numbers

Type 1 – About 1.6 million Americans, including 200,000 under 20 years old, have Type I diabetes. Type 1 diabetes is an auto-immune disease in which the body doesn’t produce insulin. It currently can’t be prevented and there is no cure. People with Type 1 diabetes are dependent on taking outside insulin since their body doesn’t make its own.

Type 2  – Over 30 million Americans have Type 2 diabetes where their body makes insulin but doesn’t use it properly, leading to unstable blood glucose levels. Type 2 diabetes can be prevented or delayed by mitigating your risk factors:

  • Prediabetes
  • Being overweight
  • An inactive lifestyle
  • A family history
  • Age over 45 years
  • A history of gestational diabetes


Control is key

Controlling diabetes requires maintaining your blood glucose level. Some complications of diabetes, Type 1 or 2, include:

  • Heart disease and stroke
  • High blood pressure
  • Kidney disease
  • Nerve damage
  • Digestive problems
  • Vision loss


Our nurses are here to help

You can talk with a MHBP registered nurse care manager who will help connect you to resources, provide education and assist with developing a diabetes management plan. 

Earn a Healthy Action reward for controlling your blood glucose level.

We can help 

Earn a healthy action incentive for controlling your blood pressure:


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