Wellness and Prevention

Preventive services can help keep you well. They include more than just seeing your primary care provider (PCP) once a year for a checkup. They include immunizations/vaccines,* lab tests, and other screenings that can help your PCP or other provider manage your health care needs.

*UPMC for You covers certain vaccines when provided by your PCP. If your PCP is unable to give the vaccine, he/she can refer you to another participating physician office. Some local pharmacies provide the vaccines but they are not covered by UPMC for You. Call our Health Care Concierge team to see which pharmacies are participating in the UPMC for You vaccine program.

Go to your PCP for preventive services. Women can go to a UPMC for You participating ob-gyn for their Pap test, pelvic exam, and mammogram. Routine physical appointments often take longer to schedule. Call well before the time you would like to schedule an appointment.

Here are some important preventive services you should know about:

Physical exam

When you go for a physical exam, your PCP will ask questions about your medical history and your family’s medical history. This is important because sometimes you may have a greater risk of having a disease if someone in your family has it. Your PCP will also check your height, weight, and blood pressure. How often you see your PCP will vary based on your age and condition, but you should see your PCP at least once a year.

Bloodwork and other tests

Based on your age, medical history, and the results of your physical exam, your PCP or other providers may order some tests. These might include bloodwork to check your cholesterol level or blood sugar, an electrocardiogram (EKG) to check your heart, or other tests. Preventive screenings can help you and your PCP find out early if you have a disease or health condition. Sometimes early treatment can save your life.

Immunizations/vaccinations

Vaccines are given to adults and children to help protect them from diseases or from getting sick. Some are for human papillomavirus (HPV), measles, mumps, pneumonia, tetanus, or the flu. It is very important for children to get all of their vaccines even if they are feeling fine. Some vaccines need to be given only once. Others need to be given at certain times as a child grows. Others work best when they are received each year.

Talk to your PCP to find out which immunizations you and your child may need. UPMC for You covers certain vaccines when provided by your PCP. If your PCP cannot give the vaccine, he or she can refer you to another participating physician office. Some local pharmacies provide the vaccines but they are not covered by UPMC for You. Call a Health Care Concierge to see which pharmacies are participating in the UPMC for You vaccine program.

Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) brochure.

A health management program has health coaches who help you better understand your disease or condition. They help you manage your health care and take better care of yourself. The right program can help you follow your provider’s plan of care and learn about your disease or condition. Your provider may talk with you about enrolling in one of these programs for better health. However, you can enroll yourself in a health management program without a referral from your PCP or other provider. You can disenroll in a health management program at any time.

UPMC for You has several health management programs. They are:

• Asthma
• Heart disease (coronary artery disease, atrial fibrillation, and congestive heart failure)
• Chronic obstructive pulmonary disease (COPD is a lung disease)
• Diabetes
• Maternity
• Hypertension (high blood pressure)
• Hyperlipidemia (high cholesterol)
• Low back pain
• Chronic kidney disease

Health coaches help make a care plan just for you. They work directly with you and your health care providers. They check your progress. Health coaches help you learn more about your condition and how to manage it. Here is how:

• They help you understand how to take better care of yourself. You will learn when you should call the doctor and what tests you may need to help you manage your health conditions.
• They tell you which preventive tests you need and how often you need them. Preventive tests help find problems early.
• They help you understand how other conditions you may have also affect your health.
• They help you follow the doctor’s orders.
• They teach you about your medications.
• They help all of your doctors and other health care providers work better together.
• They teach you how to improve your health. You will get help to quit smoking, eat better, exercise more, lose weight, and have less stress.
• They give you community resources that help with needs not covered by UPMC for You.
• They provide education through coaching phone sessions and materials that can answer your questions.

Call the Health Management Department at 1-866-778-6073 Monday through Friday from 7 a.m. to 8 p.m., and Saturday 8 a.m. to 3 p.m. TTY users should call 711.

Lifestyle coaching is offered by health coaches who can support you in making healthy changes that are important to you and your overall health. The right program can help you with goals like losing weight, quitting smoking, eating healthy, becoming more active, and learning techniques to cope with stress. You and your health coach will agree on a plan that is right for you.

You may work together on a one-time change or up to several weeks depending on your goals.

Tobacco cessation – Helps you get ready to quit and stay away from tobacco use for good.

Weight management – Helps you determine a healthy weight loss goal and create a plan to reach it.

Nutrition basics – Helps you learn about healthy eating and set realistic goals around adding healthy foods to your daily meals.

Stress management – Helps you learn and practice coping skills to manage your daily stress.

Physical activity – Helps you increase your physical activity by setting goals and creating a plan to reach them.

Your provider may talk with you about enrolling in one of these programs for better health. However, you can enroll in a lifestyle program without a referral from your PCP or other provider. You can disenroll at any time.

Call the lifestyle coaches at 1-800-807-0751 (TTY: 711) Monday through Friday from 7 a.m. to 8 p.m., and Saturday 8 a.m. to 3 p.m.