Start the new year right with Medicare preventive services
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Now is the time to get the most out of Medicare. The best way to live healthfully is by exercising, eating well, keeping a healthful weight, and not smoking.
Medicare pays for many preventive services that can pinpoint health problems early, when treatment works best. Preventive care can also lower your chances of contracting certain diseases, or keep certain illnesses from worsening.
Medicare preventive services include:
Abdominal aortic aneurysm screening: A one-time screening ultrasound for people at risk.
Alcohol misuse counseling: One alcohol misuse screening per year. Counseling may be covered if your screening result is positive.
Bone mass measurement: Helps determine whether you are at risk for broken bones. Covered once every 24 months (more often if medically necessary) for people who have certain medical conditions or meet certain criteria.
Cardiovascular screening: Helps detect conditions that may lead to a heart attack or stroke. Covered every five years to test your cholesterol, lipid, and triglyceride levels.
Colon cancer (colorectal) screening: Helps find precancerous growths in the colon, known as polyps, so they can be removed before they turn into cancer.
Counseling to stop smoking: Covered as a free preventive service.
Depression screening: By your primary care doctor once every 12 months.
Diabetes screening: Covered if you have high blood pressure (hypertension), a history of abnormal cholesterol and triglyceride levels (dyslipidemia), obesity, or a history of high blood sugar (glucose). You may be eligible for up to two diabetes screenings every year.
Diabetes self-management training: Your doctor or other health care provider must provide a written order.
EKG screening: A one-time screening EKG if you get a referral for it as a result of your one-time "Welcome to Medicare" preventive visit.
Flu shot: Covered once per flu season, in the fall or winter.
Glaucoma test: Covered once every 12 months for people at high risk for glaucoma.
Hepatitis B shot: Covered for people at high or medium risk for hepatitis B. Your risk for hepatitis B increases if you have hemophilia, end-stage renal disease, or a condition that increases your risk for infection. Other factors may increase your risk for hepatitis B, so check with your doctor. You pay 20 percent of the Medicare-approved amount, and the Part B deductible applies.
HIV screening: For people at increased risk for the infection, including anyone who asks for the test.
Mammogram: Once every 12 months for women age 40 and older.
Medical nutrition therapy services: If your doctor refers you for the service and you have diabetes or kidney disease, or if you have had a kidney transplant in the past 36 months.
Pap test and pelvic exam: Once every 24 months, or once every 12 months for women at high risk and women of child-bearing age who have had an exam that indicated cancer or other abnormalities in the past three years.
Pneumococcal shot: Most people only need this preventive shot once.
Preventive visits: One when you are new to Medicare and one each year after that.
Prostate cancer screening: A digital rectal exam and prostate-specific antigen (PSA) test every 12 months for men over age 50.
You can find additional information about preventive Medicare benefits in a booklet called "Your Guide to Medicare's Preventive Services," which also explains how services are covered if you have Part B (sometimes called fee-for-service) under Original Medicare. If you get your health coverage through a Medicare Advantage Plan such as an HMO or PPO, call your plan for more information.
The fastest way to get a Medicare publication is to use the online Medicare search tool and then view and print the publication. If you order online or by calling 800-633-4227, you will receive your order within three weeks. To look at popular Medicare publications, visit www.medicare.gov and click "Resource Locator," then "Publications and Podcasts." You can search publications by ID number or keyword. "Your Guide to Medicare's Preventive Services" is CMS Pub. No. 10110.