An Ounce of Prevention: Medicare Covered Health Screenings
As we age, taking care of our health becomes increasingly important. Regular health screenings are one way to stay on top of our health. Medicare offers various preventive services that are covered at no cost to beneficiaries. These services can help detect potential health issues early, ultimately leading to better health outcomes. This blog will discuss the Medicare-covered health screenings and what you need to know.
What Part Of Medicare Covers Preventative Services?
Medicare Part B is the part of Medicare that covers preventive services. Part B is designed to help cover medically necessary services and preventive care that can help detect and prevent illnesses before they become more serious. This includes various screenings for cancer, cardiovascular disease, diabetes, and other chronic conditions, vaccinations, and annual wellness visits. Part B also covers other medically necessary services such as doctor visits, outpatient care, and medical equipment. Preventive services covered under Medicare Part B are available at no cost to eligible beneficiaries. They can access the care they need to stay healthy without worrying about out-of-pocket costs. By covering preventive services, Medicare Part B helps ensure that beneficiaries receive the care they need to maintain good health and prevent future health problems.
What is Medicare Preventive Services?
Medicare preventive services are designed to help keep you healthy by identifying potential health problems before they become more serious. These services are covered by Medicare Part B and are available at no cost to eligible beneficiaries. Some preventive services require a copayment or deductible, so it's essential to check with your provider to determine your coverage.
Medicare preventive services include:
Welcome to Medicare Preventive Visit: This is a one-time visit within the first 12 months of Medicare enrollment. During this visit, your healthcare provider will review your medical history, current health status, and recommend preventive services that you may need.
Annual Wellness Visit: This visit is available to Medicare beneficiaries who have had Part B coverage for over 12 months. This visit includes a review of your medical history, measurements of vital signs, and a discussion of any potential health risks. Your healthcare provider may also recommend preventive services during this visit.
Colorectal Cancer Screenings: Medicare covers various types of colorectal cancer screenings, including colonoscopies, fecal occult blood tests, and flexible sigmoidoscopies. These screenings are available to individuals over the age of 50 and are recommended every 10 years.
Mammograms: Medicare covers mammograms once every 12 months for women over the age of 40. Your healthcare provider may recommend more frequent screenings if you have a family history of breast cancer or other risk factors.
Prostate Cancer Screenings: Medicare covers digital rectal exams and prostate-specific antigen (PSA) tests for men over 50. These screenings are recommended annually.
Cardiovascular Screenings: Medicare covers cardiovascular screenings that include tests for cholesterol, blood pressure, and body mass index (BMI). These screenings are available to individuals with a history of cardiovascular disease or risk factors such as smoking, high blood pressure, or high cholesterol.
Diabetes Screenings: Medicare covers diabetes screenings for individuals with a history of high blood pressure, abnormal cholesterol levels, or obesity. These screenings are also available to individuals with a history of gestational diabetes or who are over the age of 65.
Vaccinations: Medicare covers various vaccines, including the flu vaccine, pneumococcal vaccine, and hepatitis B vaccine. These vaccines are recommended for individuals over the age of 65 and individuals with certain medical conditions.
In addition to the services listed above, Medicare also covers a range of other preventive services, including depression screenings, HIV screenings, and lung cancer screenings. These services are available to eligible beneficiaries and can help detect potential health issues early.
What Preventative Services Aren’t Covered Under Medicare Part B?
While Medicare Part B covers a wide range of preventive services, there are certain preventive services that are not covered under this part of Medicare. Some of the preventive services that are not covered by Medicare Part B include:
Routine dental care, including cleanings, fillings, and extractions.
Routine vision care, including eye exams, eyeglasses, and contact lenses.
Hearing exams and hearing aids.
Foot care, including routine foot exams and treatment for corns, calluses, and toenail clipping.
Acupuncture, except in certain circumstances.
Cosmetic procedures, such as plastic surgery or wrinkle treatments.
Health club memberships or fitness programs.
It's important to note that while these preventive services may not be covered under Medicare Part B, they may be covered under other parts of Medicare, such as Medicare Advantage plans. In addition, some of these services may be covered under certain circumstances, such as when they are deemed medically necessary to treat a specific health condition. Beneficiaries should check with their healthcare provider and their Medicare plan to determine which preventive services are covered under their plan.
What are the Costs of Medicare Part B Preventative Services?
The cost of Medicare Part B preventive services can vary depending on the service and whether the beneficiary has met their deductible for the year. In general, many preventive services are covered at no cost to the beneficiary, meaning that they are available at no additional cost beyond the monthly Part B premium.
For example, beneficiaries can receive an annual wellness visit at no cost, which includes preventive services such as blood pressure and cholesterol screenings. Similarly, many preventive screenings, such as mammograms and colonoscopies, are covered at no cost to the beneficiary.
However, some costs may be associated with other preventive services covered under Medicare Part B. For example, some vaccinations, such as the shingles vaccine, may require a copayment or coinsurance. Additionally, suppose a beneficiary receives a preventive service during a doctor's visit that is not classified as a preventive visit. In that case, they may be responsible for a copayment or coinsurance for the visit itself.
Beneficiaries need to check with their healthcare provider and Medicare plan to determine the specific costs associated with any preventive service they may need. Sometimes, the costs may vary depending on the provider or facility where the service is received. Overall, however, Medicare Part B preventive services are designed to be affordable and accessible to eligible beneficiaries, helping promote good health and preventing chronic conditions' onset or progression.
For a full list of Medicare approved screening services, please visit: https://www.medicare.gov/coverage/preventive-screening-services