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Medicare Members: Take Advantage of Your Covered Preventive Services

August 25, 2017

Preventive health care can help detect diseases early — when they’re easiest to treat. That’s good news for qualified Medicare beneficiaries, because many preventive services are covered by Medicare

Get the Preventive Benefits You’ve Earned, Including Annual Doctor Visits

It’s smart to take advantage of your Welcome to Medicare preventive visit.

  • Go see your doctor during the first 12 months of being a Medicare beneficiary with Part B coverage for this important preventive visit.
  • Your visit will include a review of both your medical and social history (as it relates to your health), plus education about services like recommended screenings, shots and referrals for other care if you need.

Qualified Medicare beneficiaries who’ve had Part B for at least a year can also get an annual wellness visit. When you set this appointment, be sure to let your doctor’s office know that it’s your yearly wellness visit, which is included in your Medicare coverage once every 12 months. During your visit, you can expect to fill out a Health Risk Assessment questionnaire and receive:

  • A review of your medical and family history.
  • Height, weight, blood pressure, and other routine measurements.
  • Detection of any cognitive impairment.
  • Personalized health advice.
  • A list of risk factors and treatment options for you.
  • A screening schedule (like a checklist) for appropriate preventive services.
  • The option to include an advance care planning discussion.

Keep in mind, you’re entitled to these preventive services — whether you get your benefits through Original Medicare (specifically Part B) or choose to get your benefits through a Medicare Advantage (Part C) from a private insurer.

What Other Preventive Care Is Covered At No Cost?

If you are considered at risk or otherwise eligible, Medicare covers 100% of its approved amount (with no Part B deductible) for all of these services:

  • Abdominal aortic aneurysm screening.
  • Alcohol misuse screening.
  • Bone mass measurement.
  • Breast cancer screening/mammogram.
  • Cervical and vaginal cancer screening.
  • Depression screening.
  • Diabetes screening.
  • EKG heart screening.
  • Flu shot.
  • Hepatitis B shots.
  • Hepatitis C screening.
  • HIV screening.
  • Laboratory services.
  • Lung cancer screening.
  • Medical nutrition therapy.
  • Obesity screening and counseling.
  • Pneumonia shots.

Medicare coverage also extends to these services, but with a few limitations:

  • Cardiovascular heart disease screening — screenings are free, but the doctor visit may require a copay.
  • Colon colorectal cancer screening — the colonoscopy test is free, but there may be a copay for polyp removal.
  • Glaucoma screening — 80% of the Medicare-approved amount is covered, after you pay the Part B deductible.
  • Prostate cancer screening — the PSA test is free with no Part B deductible; for a digital rectal exam, 80% of the Medicare-approved amount is covered after you pay the Part B deductible.
  • Sexually Transmitted Illness (STI) screening and counseling — free if your doctor orders tests and they are performed in a Medicare-approved lab.
  • Smoking cessation counseling — free for those who do not have a smoking-related illness; 80% covered for those who do.

Keep in mind, the Medicare-approved amount assumes your doctors and other providers accept it as payment in full, which is known as “assignment.” If you get your services from someone who doesn’t accept assignment, you might pay more. Even if you do, it can still be a great investment in your overall health.

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A CONSUMER’S GUIDE TO HEALTH INSURANCE FOR PEOPLE ELIGIBLE FOR MEDICARE MAY BE OBTAINED FROM YOUR LOCAL SOCIAL SECURITY OFFICE OR FROM THIS INSURER

Empire BlueCross BlueShield is an HMO plan with a Medicare contract. Enrollment in Empire BlueCross BlueShield depends on contract renewal. Services provided by Empire HealthChoice HMO, Inc. licensee of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield plans.

Services provided by Empire HealthChoice Assurance, Inc., licensee of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield plans. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or co- payments/co-insurance may change on January 1 of each year. You must continue to pay your Medicare Part B premium.

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