I am a Columbia grad student. I'm a 35 year-old woman and I'm a bit concerned about what primary care services are offered to me. I tried to make an appointment for an annual exam, and it seems this is only a pap. But I've never had a blood lipid exam done (not even a cholesterol check), and my understanding is that after 30, a complete blood lipid exam is done.
I'd like to know what I should have done for preventive primary care as a 35 y.o. female, and what of those services are offered through health services and which I'll have to go outside of health services. I should have had this figured out by now, but the most I ever do — and it seems the most that Health Services even offers — is the pap smear. As I grow older, I know that there should be more. Personally, I think the routine primary health care needs of older students should be served by Health Services, so I'm hoping I can get other things done — whatever they may be — performed there as well.
As the adage goes, “Life begins at 30!” You are absolutely correct that there are recommendations for preventive health care for women over 30. While you may need to go off-campus for a few of your medical needs, Columbia Health on the Morningside campus and the Student Health Service on the Medical Center campus offer significantly more than just a Pap smear. If you are enrolled in the Columbia Student Health Insurance Plan, you are covered for a comprehensive set of medical and mental health services from on- and off-campus health care providers. If you are not enrolled in the student health insurance plan, it’s best to contact your health insurance company to find out details about your medical coverage. Regardless of your insurance coverage, any Columbia student who has paid either the Columbia Health Fee (Morningside) or the Student Health Service fee (CUMC) can access medical and mental health services on campus (Any student who is considered full-time or who has enrolled in the student health insurance plan will be automatically assessed the health fee at their campus with their tuition). For 30-plus women, there are a few routine tests that are recommended to make sure that all systems are functioning as they should. You may want to consider getting the following recommended tests:
- Blood pressure readings at least every two years for early detection of high blood pressure, which can put you at greater risk of heart attack, stroke, heart failure, and kidney damage.
- Clinical breast exams conducted by a health care provider are recommended for all women in their 20s and 30s at least once every three years. Mammograms aren't typically recommended for women ages 40 and younger. However, speaking with your health care provider, based on your personal health history and risk factors, will help determine when to start getting mammograms and how often to get them.
- Pap smears are recommended at least every three years — beginning at age 21 or after first becoming sexually active – and continuing until age 65. According to the U.S. Department of Health and Human Services, women over 30 may opt to instead have a combination Pap smear and human papillomavirus (HPV) test every five years. Women who have had complete hysterectomies may talk with their health care provider about whether or not Pap smears are still needed.
- Sexually transmitted infection (STI) testing is also a recommended part of gynecological checkups. People between the ages of 15 and 65 are encouraged to get tested for HIV. People who have ever injected drugs or received a blood transfusion before 1992 are also advised to be tested for hepatitis C. Sexually active women are encouraged to get tested for chlamydia, gonorrhea, and syphilis.
- Cholesterol tests, as you mentioned, are recommended starting at age 20. You can talk with your health care provider about how often you need to be tested. This test measures the fats (lipids) in your blood to evaluate the level of cholesterol and triglycerides.
- Dental cleanings are recommended annually to thoroughly clean your mouth and to check for any conditions that may need attention.
Of these recommended tests, blood pressure screenings, Pap smears, STI testing, and cholesterol/lipid screenings can be done on campus. You can also get standard physical exams on campus. Mammograms are done off campus because Columbia doesn't have the necessary equipment for them, but the procedure is covered through the Columbia Student Health Insurance Plan for women over the age of 35 or with a family or personal history of breast cancer. Women with a prior history of breast cancer are covered for more frequent mammograms. Your primary care provider on campus can give you a referral to a mammogram provider.
If you choose to enroll in the Aetna Advantage Dental Plan (optional for Columbia students), cleanings are done off-campus through a provider on Aetna's provider list. Other off-campus services, like long-term mental health care or chiropractic work, are covered by Columbia's health insurance if you have a referral from your campus health care provider. Of course, in an emergency, you can always seek treatment without a prior referral; the cost of emergency treatment, such as a co-pay for an emergency hospital admission, are outlined in the Columbia Student Health Insurance Plan for both Morningside and Medical Center students.
During your annual checkup, take the opportunity to talk with your health care provider and address any additional health concerns you may have, such as vaccination recommendations, weight issues, alcohol and tobacco use, diet, sleep, exercise, and mental health issues. Regular checkups also help you maintain strong relationships with your provider(s), which can make life a lot easier if you find yourself ill and in need of care. To health!Alice!