Managing Your Health While Avoiding COVID-19

June 29, 2020

Has your fear of coronavirus also induced a fear of going to your doctor for non-COVID symptoms, regular checkups, or recommended health screenings? By using telemedicine options or making sure your doctor’s office is observing safety guidelines for patients and staff, you can fearlessly visit your healthcare provider online or in person. By maintaining continuity of care, you can avoid negative consequences from delayed preventive, chronic, or routine care. 

Telemedicine

During the COVID-19 pandemic, you don’t have to choose between medical care and social distancing if you use telemedicine options available from your provider’s office. Remote access also can help preserve the patient-provider relationship at times when an in-person visit is not practical or feasible. 

Telemedicine can be a beneficial way to address mental health concerns for the majority of patients. Many patients are comfortable in their own home, scheduling is often more convenient, concerns with transportation and time may be reduced, and adolescents and young adults especially are comfortable using technology to communicate. Telemedicine also can reach patients in rural areas where behavioral health professionals are otherwise in limited supply. Remote access to healthcare services may increase participation for those who are medically or socially vulnerable or who do not have ready access to providers.

In Person

Safety guidelines for healthcare providers’ facilities from the Centers for Disease Control (CDC), the U.S. Department of Health & Human Services, and the World Health Organization include the following recommendations for waiting areas, patient examination rooms, labs, and restrooms:

• Provide supplies—tissues, alcohol-based hand sanitizers, soap at sinks, trash cans, and face masks.
• Place chairs at least 6 feet apart. 
• If your office has toys, reading materials, or other communal objects, remove them or clean them regularly.
• Clean areas often with attention to frequently-touched surfaces including doorknobs, armrests, and handrails.
• Fully clean and disinfect exam rooms between each patient. 
• Require the use of face masks by staff, patients, and accompanying visitors.

This issue of InsureYouKnow provides preventive health guidelines for the general adult population, based on the recommendations of recognized clinical sources such medical associations and government entities, including the CDC and the United States Preventive Services Task Force. An individual patient’s medical history and physical examination may indicate that further medical tests are needed. Guidelines may also differ from state to state based on state regulations and requirements. 

Insurance Coverage

Some tests and vaccinations may not be covered by Medicare or by your health insurance plan, so it’s important to check on your specific coverage before obtaining them. Some insurance companies are currently not only waiving copayments and deductibles for COVID-19 related diagnoses and treatments, but also for telehealth and in-person visits for non-COVID concerns.

Screening Recommendations

• Routine Health Examination: every visit or at least, based on age and insurance contract, your healthcare provider will perform an exam that includes height and weight, calculation of body mass index, obesity determination, and blood pressure measurement. 
• Abdominal Aortic Aneurysm: one-time screening with ultrasonography in men ages 65 to 75 years who have ever smoked.            
• Breast Cancer: mammography and physician breast exam: annually for women ages 40 and over; breast self-exams: recommended monthly for women beginning at age 20. 
• Cervical Cancer: Pap/Human Papilloma Virus (HPV) testing: for women ages 21 to 65, or starting 3 years after the onset of sexual activity, annually without HPV test to age 30; Pap test with HPV test every 3 years after age 30. Women who have had a hysterectomy or are over age 65 may not need a Pap test.
• Colorectal Cancer: for men and women ages 50 to 75 (in certain situations, also may be advisable from ages 75 to 85). Colonoscopy: for men and women, every 10 years. Other screening tests are: Fecal Immunochemical test: stool blood test, every 1-3 years, and CT colonography (an x-ray examination): every 5 years.
• Lung Cancer: annually with low-dose computed tomography in adults ages 55 to 80 years who have a history of heavy smoking and currently smoke or have quit within the past 15 years. 
• Prostate Cancer: Digital rectal exam (DRE) and prostate specific antigen (PSA) test/discussion with physician: annually for men 50 and over (starting at age 40 for African-Americans).
• Cholesterol: Lipid Panel, including LDL: every 5 years, or more frequently based on results and risk profile for all men and women starting at age 20, or earlier if cardiac risk profile reveals high risk.
• Diabetes: Fasting Plasma Glucose or Random Plasma Glucose: men and women with high blood pressure, are overweight, or have cardiovascular risk factors; all others age 45 and over. 
• Hepatitis B: screen persons at high risk for infection (such as geographic location, HIV positive, immunocompromised); screen pregnant women at their first prenatal visit.
• Hepatitis C: one-time testing of all adults 18 and all pregnant women during every pregnancy. People with risk factors, including people who inject drugs, should be tested regularly.
• Human Immunodeficiency Virus (HIV) Infection: screen in adults age 13 to 65 years and younger adolescents and older adults at increased risk; all pregnant women.
• Hypertension: blood pressure measurement every 1-2 years for all men and women, regardless of age.
• Osteoporosis: DXA (bone-density testing): baseline testing with follow-up intervals based on test results for women ages 65 and over, or starting at menopause if additional risk factors exist. 
• Sexually Transmitted Infections (STIs): screen sexually active and those at high risk for syphilis, chlamydia, and gonorrhea and offer intensive behavioral counseling for adults who are at increased risk for STIs.

 Immunization/Vaccine Recommendations

• Diphtheria/Tetanus/Pertussis: one time in place of Diphtheria/Tetanus Booster for men and women ages 19 to 64.
• Diphtheria/Tetanus: every 10 years for men and women up to age 65; single vaccination only for men and women 65 or over.
• Human Papillomavirus (HPV): one series of three vaccines for females between ages 11 and 26, and men, two to three doses depending on age at time of initial vaccination; age 19-21 if not already given.
• Influenza (Flu): annually for high-risk adults of any age with diabetes or heart, lung, kidney or immune disease; annually for all adults ages 50 and over; annually for any adult desiring immunization, regardless of age.
• Pneumococcal (for Pneumonia): one dose of PCV 13 and one dose of PCV 23 at least one year after PCV 13 for adults ages 65 and over who are at average risk, for high-risk adults of any age with diabetes, cancer, or heart, lung, or immune disease, Initial vaccination, with single revaccination 5 years later.
• Varicella Zoster (for Shingles): two doses starting at age 50; single vaccination for adults ages 60 and older.

Mental Health Awareness

• Physical Exam: Your primary care provider may give you a physical exam and ask you about your feelings, mood, behavior patterns, and other symptoms. Your provider may also order a blood test to find out if a physical disorder may be causing mental health symptoms.
• Coping with Stress: The COVID-19 pandemic is stressful for many people. Public health actions, such as social distancing, can make people feel isolated and lonely and can increase stress and anxiety. However, these actions are necessary to reduce the spread of COVID-19. Coping with stress in a healthy way will make you, the people you care about, and your community stronger. Know where and how to get treatment and other support services, including counseling or therapy in person or through telehealth services. Free and confidential resources can also help you connect with a skilled, trained counselor in your area.
• Domestic/Intimate Partner Violence: screening and counseling for interpersonal and domestic violence should be addressed immediately. The CDC provides a list of services to assist victims of violence.

Prescriptions

• Doctor visits and approvals as well as lab results are sometimes required in order to obtain or renew prescriptions. 

Although health care news covered daily focuses on COVID-19, it’s important not to neglect other medical issues for which you should seek attention and advice from your healthcare professional.

At InsureYouKnow.org, you can save your medical files, lab results, and a list of prescriptions. You also can set up alerts to prompt you to schedule appointments to keep you on track to stay healthy.