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Savvy Senior: What To Know About Medicare Coverage Of Preventive Care - Cincinnati Enquirer

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Medicare Preventative Services: Coverage And Cost - Healthline

Preventive care How often? Medicare requirements Cost to you abdominal aortic aneurysm screening once referral from your medical professional $0 alcohol misuse screening once every 12 months you must be an adult who has not received a diagnosis of alcohol misuse disorder $0 alcohol misuse counseling 4 sessions every 12 months one of these must be true: you're estrogen-deficient and at risk for osteoporosis; an x-ray shows osteoporosis or fractures; you're taking prednisolone or other steroids; your doctor is monitoring your osteoporosis drug therapy $0 bone density screening once every 24 months one of these must be true: you're estrogen-deficient and at risk for osteoporosis; an x-ray shows osteoporosis or fractures; you're taking prednisolone or other steroids; your doctor is monitoring your osteoporosis drug therapy $0 cardiovascular disease once every 5 years screening includes tests for cholesterol, lipids, and triglycerides $0 cardiovascular behavior therapy once every 12 months therapy must take place in a primary care setting $0 cervical/vaginal cancer screening once every 24 months one of these must be true: you're estrogen deficient and at risk for osteoporosis; an x-ray shows osteoporosis or fractures; you're taking prednisolone or other steroids; your doctor is monitoring your osteoporosis drug therapy $0 colorectal cancer (CRC) screen: multi-target stool DNA once every 3 years 20% of the cost, plus any hospital copay $0 CRC blood-based biomarker screening tests once every 3 years you must be between 45 and 85, have no CRC symptoms, and have an average risk level $0 CRC screen: barium enema once every 48 months tests include HPV and breast cancer screenings; If you had a positive pap test or you're at high risk, you have a screening once per year 20% of cost, plus copay CRC screen: colonoscopy once every 24 months you must be 45 or older; if you're at high risk, you have a screening once every 24 months 20% of the cost of polyp removal CRC screen: fecal occult blood test once every 12 months you must be 45 or older and have a referral $0 CRC screen: sigmoidoscopy once every 48 months you must be at high risk; if you aren't at high risk, you can be screened once every 120 months if you have a biopsy, you may pay coinsurance or a copay depression once every 12 months screening must happen in a primary care setting $0 diabetes screening twice every 12 months 20% of the cost, plus any hospital copay $0 diabetes self-management training 10 hours initially 20% of the cost, plus any hospital copay 20% of the cost glaucoma screening once every 12 months you must be 45 or older; if you aren't at high risk, you can be screened once every 120 months 20% of cost, plus any hospital copay hepatitis B virus infection screening once every 12 months one must be true: you have diabetes; you have a family history of glaucoma; you're Black and over age 50; you're Hispanic and over age 65 $0 hepatitis C virus infection screening once every 12 months your doctor must order it, plus: you must be high risk, you must have had a blood transfusion before 1992, or you must have been born between 1945 and 1965 $0 HIV once every 12 months you must be 15 to 65 years old or at high risk $0 lung cancer screening once every 12 months you must be at high risk; if you're pregnant, you can be screened three times during pregnancy $0 mammogram once every 12 months you must be 50 to 77 years old and have no symptoms, or you must be a smoker (or have a history of 20 "pack years"; your doctor must order this test if your test is diagnostic, you pay 20% of the cost nutrition therapy 3 hours the first year, 2hours each year after that your doctor must write a referral, and you must have diabetes, renal disease, or have had a kidney transplant within the last 3 years $0 obesity screening one initial screening, plus behavioral therapy sessions you must have a body mass index of 30 or more; screening must happen in a primary care setting $0 prostate cancer screening once every 12 months screening includes a digital exam and a blood test $0 for exam, 20% for blood test sexually transmitted infection screening once every 12 months screening includes chlamydia, gonorrhea, syphilis, and hepatitis B; two 20- to 30-minute counseling sessions are included $0 flu shot once each flu season — $0 COVID-19 vaccines 2023-2024 formula — $0 hepatitis B shots — you must be at medium to high risk $0 pneumococcal shots 2 shots they must be at least 1 year apart $0 smoking cessation counseling 8 visits every 12 months — $0 wellness visit once every 12 months — there may be coinsurance if your doctor runs extra tests Welcome to Medicare examination once within 12 months of enrolling in Medicare Part B — $0

Did You Know Medicare Annual Wellness Visits Are Voluntary?

A Medicare Annual Wellness Visit (AWV) is a yearly appointment with your healthcare provider that's designed to develop or update a personalized prevention plan. The goal is to help prevent disease and disability based on your current health and risk factors. Here's what you can generally expect during an AWV:

1. Health Risk Assessment: You'll fill out a questionnaire to provide information about your health, including your medical and family history, lifestyle, and risk factors.

2. Vital Measurements: Your height, weight, blood pressure, and other routine measurements may be taken.

3. Health History Review: Your healthcare provider will review your medical history and discuss any changes since your last visit.

4. Medication Review: You'll review all the medications you take, including prescription drugs, over-the-counter medications, and supplements.

5. Screening Schedule: Your provider will review and update your screening schedule for preventive services, such as cancer screenings, immunizations, and other necessary tests.

6. Personalized Prevention Plan: Based on your health status and risk factors, your provider will develop or update a personalized plan to help prevent illness. This plan may include recommendations for lifestyle changes, screenings, and preventive services.

7. Cognitive Assessment: An assessment to detect any signs of cognitive impairment, such as memory loss or confusion, may be performed.

8. Advance Care Planning: If you wish, you can discuss advance care planning, which includes making decisions about the care you would want to receive if you became unable to speak for yourself.

The AWV is covered once every 12 months under Medicare Part B, and you typically don't have to pay anything for this visit if your doctor accepts assignment.

You do not have to attend your annual wellness visit if you don't want to. It's entirely voluntary. However, it can be quite beneficial to your overall health and well-being. The purpose of the annual wellness visit is to create or update a personalized prevention plan to help prevent disease and disability based on your current health and risk factors. It's a great opportunity to discuss any health concerns you might have and stay on top of preventive measures.

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