 Staying
healthy is important at any age, and Medicare covers some preventive
services to help you stay healthy.
What
are preventive services?
There
are steps you can take to lower your risk of disease and illness,
and Medicare is providing coverage of these services to help you
stay healthy. Medicare provides preventive services and wellness
support by helping to pay for:
-
Screenings for breast, cervical, and colorectal cancer.
- Bone
mass measurements for osteoporosis.
- Diabetes
self-management and blood glucose monitoring.
- Flu
and pneumonia vaccinations.
These
benefits from Medicare can be a key to long lasting good health.
Talk with your doctor about the various screenings, vaccinations,
and health management programs that are available as a Medicare
benefit. Your doctor can help you determine your health risks and
need for these preventive screenings.
In
addition to the preventive services that are part of your Medicare
coverage, you should be aware of other wellness activities that
can keep you healthy. These include peptic ulcer screening and education
and end-stage renal disease (ESRD) education.
The
following chart shows you what health screenings are provided as
a Medicare benefit and the portion of the cost that Medicare will
pay.
| COVERED
SERVICE |
ELIGIBLE
BENEFICIARIES |
WHAT
YOU PAY |
Screening
Mammogram:
Once per year |
All
female Medicare beneficiaries age 40 and older. |
20%
of the Medicare approved amount with no Part B deductible. |
Pap
Smear and Pelvic Exam:
(Includes a clinical breast exam)
Once every three years. Once per year if you are at high
risk for cervical or vaginal cancer, or if you are of child
bearing age and have had an abnormal Pap Smear in the preceding
three years. |
All
female Medicare beneficiaries. |
No
coinsurance and no Part B deductible for the Pap Smear.
For
all other exams, 20% of the Medicare approved amount with
no Part B deductible.
|
|
Colorectal
Cancer Screening:
Fecal
Occult Blood Test
Once every year
Flexible
Sigmoidoscopy
Once every four years
Colonoscopy
Once every two years for high risk
Barium
Enema
Doctor can substitute for sigmoidoscopy or colonoscopy
|
All
Medicare beneficiaries age 50 and older, however, there is no
age limit for having a colonoscopy. |
No
coinsurance and no Part B deductible for the fecal occult
blood test.
For
all other tests, 20% of the Medicare approved amount after
the annual Part B deductible.
|
Diabetes
Monitoring:
Includes coverage for glucose monitors, test strips and lancets
without regard to the use of insulin. |
All Medicare beneficiaries with diabetes. |
20%
of the Medicare approved amount after the annual Part B deductible. |
Bone
Mass Measurements:
Varies with health status of beneficiary |
Medicare
beneficiaries at risk for losing bone mass. |
20%
of the Medicare approved amount after the annual Part B deductible. |
|
Flu
Shot
Once per year
Pneumococcal
Vaccination
One may be all you ever need - ask your doctor
Hepatitis
B Vaccination
If you are at high or intermediate risk for hepatitis.
|
All
Medicare beneficiaries. |
No
coinsurance and no Part B deductible for flu or pneumococcal
vaccinations if doctor accepts assignment. Hepatitis B vaccination,
20% of the Medicare approved amount after the Part B deductible. |
Who's
eligible for Medicare?
Generally,
you are eligible for Medicare if you or your spouse worked for at
least 10 years in Medicare-covered employment and you are 65 years
old and a citizen or permanent resident of the United States. You
might also qualify for coverage if you are a younger person with
a disability or with chronic kidney disease.
Here
are some simple guidelines.
You
can get Part A at age 65 without having to pay premiums if:
- You
are already receiving retirement benefits from Social Security
or the Railroad Retirement Board.
- You
are eligible to receive Social Security or Railroad benefits but
have not yet filed for them.
- You
or your spouse had Medicare-covered government employment.
If
you are under 65, you can get Part A without having to pay premiums
if:
-
You have received Social Security or Railroad Retirement Board
disability benefits for 24 months.
- You
are a kidney dialysis or kidney transplant patient.
While you do not have to pay a premium for Part A if you
meet one of those conditions, you must pay for Part B if you
want it.
- Part
A (Hospital Insurance) helps pay for care in hospitals, skilled
nursing facilities, hospice, and some home health care.
- Part
B (Medical Insurance) helps pay for doctors, outpatient hospital
care, and some other medical services that Part A does not cover,
such as the services of physical and occupational therapists,
and some home health services.
If
you have questions about your eligibility for Medicare, or questions
about your coverage, go to http://www.medicare.gov/
or call 1-800-MEDICARE (1-800-633-4227, TTY/TDD: 1-877-486-2048
for the hearing and speech impaired.)
Use
your PersonalMD.com
Personal Medical Record to keep track of the
preventive care you have received, as well as to store your Medicare
coverage information (for example, in an Efile you name "Medicare.")
Source:
US Department of Health and Human Services, Health Care Financing
Administration
|
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