Using Medicare for Prevention
Q: Can I use Medicare coverage for tests that might prevent illness?
A: Yes. Over time, Medicare has added more and more preventive benefits, but many seniors either don’t know about them, or don’t use them. Here is a partial list of some of the preventive services that elders should be aware of:
Bone Mass Measurement: Medicare will pay for 80% of the cost of a bone mass test, which can help diagnose osteoporosis, leading to earlier treatment of this potentially harmful condition.
Colorectal Cancer Screening: Colorectal cancer is the second leading cause of cancer deaths, with 90% of victims over the age of 50. Medicare will pay 100% of the cost of a fecal occult blood test, the simplest test to take—yet nine out of ten elders don’t take it. Medicare will cover 80% of approved charges for a sigmoidoscopy test every two years, or a full colonoscopy test as often as every 2 years if you are at high risk for colon cancer. Medicare also covers a barium enema. It is estimated less than 40% of colon cancer cases are detected early.
Diabetes Monitoring: Medicare will cover 80% of the cost of glucose monitors, test strips, and lancets. It will also pay to train people in the self-management of diabetes and medical nutritional therapy. Starting in January 2002, you can get nutritional diagnosis, therapy, and counseling services from a registered dietitian to help manage diabetes.
Mammogram screening: All women on Medicare age 40 and older can get one baseline mammogram every year, with Medicare picking up 80% of the cost.
Pap Smear and Pelvic Exam: Medicare will pay for 80% of one pap test every two years, and the same with a pelvic exam. Certain high-risk women can get these tests every year.
Prostate Cancer screening: All men on Medicare age 50 and older can get 80% of the cost of a prostate specific antigen (PSA) test every year, and a digital rectal exam.
Flu & Pneumonia Vaccinations: Everyone on Medicare can get a free flu and pneumonia shot. You can get a flu shot once a year, and one pneumonia shot could be all you ever need. Medicare will also cover 80% of the cost of a hepatitis B shot.
Glaucoma Screening: Beginning January, 2002, a person on Medicare considered high-risk for glaucoma (such as a family history of glaucoma or diabetes), can get 80% coverage by Medicare for glaucoma screening from an optometrist or ophthalmologist.
For more information on Medicare’s preventive benefits, call 1-800-MEDICARE and ask for publication 10110. Or on the Internet go to the Medicare publications site. Remember, a pound of prevention is worth more than an ounce of prevention.