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Medicare Preventive Services: What is Covered?
As the saying goes "an ounce of prevention is worth a pound of cure," and as you get older, taking preventative measures can keep you healthy. And if you are a Medicare beneficiary, there are a number of preventive services available to you.
Unfortunately, the government reports that fewer than one in 10 recipients is getting all the screenings and immunizations recommended by public health groups.
Anyone with Medicare Part B has access to the following preventive services:
- Initial physical exam. If your Medicare Part B coverage begins on or after January 1, 2005, Medicare will cover a one-time "Welcome to Medicare" preventive physical exam within the first six months that you have Part B. Additionally, those at risk for abdominal aortic aneurysms may be referred for a one-time ultrasound at their initial exam.
- Cardiovascular screening. Medicare covers one test every five years to check your cholesterol and other blood fat levels.
- Cancer tests. Medicare covers breast cancer screening (mammograms) once a year for women over age 40; cervical and vaginal cancer screening (pap test and pelvic exam) once every two years for all women; colon cancer screening (colorectal) every year to every four years, depending on the test; and prostate cancer screening (PSA) every year for men.
- Shots. Medicare covers flu, pneumococcal, and Hepatitis B immunizations.
- Bone mass measurements. Medicare covers bone mass measurements to check if you are at risk for fracture due to osteoporosis. The test is covered once every 24 months.
- Diabetes. Medicare covers up to two diabetes screenings per year. In addition, it covers glucose monitors, test strips, and lancets for individuals with diabetes and offers self-management training.
- Glaucoma tests. One glaucoma test is covered each year for people at high risk for glaucoma.
- Counseling to quit smoking. Medicare recipients who are diagnosed with a smoking-related disease, including heart disease, cerebrovascular disease (stroke), multiple cancers, lung disease, weak bones, blood clots, and cataracts, can get coverage for smoking and tobacco use cessation counseling.
- Medical nutrition therapy. Medical nutrition therapy services are covered for people with diabetes or renal disease when referred by a doctor.
For some of these tests, beneficiaries in regular Medicare pay nothing; for other tests, Part B's copayment applies. The Affordable Care Act ("Obamacare") enhanced Medicare's preventive services offerings. For details, click here.
To download a copy of Medicare's Your Guide to Medicare's Preventive Services, click here.
For more information from Medicare.gov about what preventive services are covered, click here.
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