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The most common causes of death for Medicare patients are heart disease, cancer, stroke and diabetes. All of these diseases and medical problems can be treated effectively if they are caught early. Preventive health care helps detect diseases and medical problems before they become too big to treat. Certain cancers have significantly greater recovery and remission rates when they are detected early. Preventive care also helps prevent diseases through the careful review of vital health signs such as cholesterol and blood sugar levels.
Medicare health insurance plans, including Original Medicare and Medicare Advantage Plans, cover a number of preventive care services. According to the new health care law, many of these preventive health care services may be provided free of charge to Medicare beneficiaries depending on the type of Medicare plan they have. Actual out-of-pocket expenses will be determined by the type of service provided and the beneficiary's plan.
Important preventive care services recommended by Medicare and covered by Medicare health insurance plans include:
- Cardiovascular Screenings. Heart disease is a leading cause of death every year in the United States. Medicare covers cardiovascular screenings to test your cholesterol, lipid, and triglyceride levels once every five years. These screenings can reduce your risk of heart attack by giving your doctor the information he or she needs to determine the health of your heart and the likelihood of a heart attack. If your doctor determines you have an elevated risk of heart disease, he or she can suggest dietary and lifestyle changes that can reduce your risk.
- Colorectal Cancer Screenings. Colon cancer can be extremely difficult to treat if caught late. Colorectal cancer screenings help catch colon cancer early, which is when treatment works best. There are numerous screening tests available, such as special blood tests or colonoscopy procedures. Your doctor can best determine your level of risk and which screening test is right for you. Medicare will cover these tests if you are at least fifty years of age or are considered high-risk for colon cancer. How often the tests are covered depends on your level of risk and the type of test. Check with your plan if you have questions about whether a particular test is covered.
- Diabetes Screenings. People with Medicare who have high blood pressure, a history of abnormal cholesterol or triglyceride levels, are obese, or have a history of high blood sugar are eligible for a diabetes screening. Screenings are also covered if you have two of the following risk factors: you are at least 65 years of age, you are overweight, you have a family history of diabetes, or you have a personal history of diabetes during pregnancy. If you have delivered a baby who weighed more than 9 pounds at birth, you may also be eligible for the screening. Depending on the results of your screening, you may be eligible for additional screenings every two years.
- Mammograms. If you are a female over the age of 40, And on Medicare, your coverage includes a mammogram every twelve months. Mammograms are X-rays designed to check for breast cancer. As in most cancers, early detection will mean easier and more successful treatment.
- Pap Tests, Pelvic Exams, and Clinical Breast Exams. All women on Medicare are eligible for a Pap test and pelvic exam every twenty-four months. Women at high risk for vaginal or cervical cancers are eligible for an exam every twelve months. Again, early detection is key to successful treatment.
- Prostate Cancer Screening. All men over the age of fifty who have Medicare coverage are eligible for a digital rectal exam and a Prostate Specific Antigen test every twelve months. As always, early detection is key for the successful treatment of prostate cancer.
General Tips:
Less common but important preventive care services include bone mass measurements which can help screen for osteoporosis—a common and dangerous medical condition that mostly affects older women, flu shots, Glaucoma tests, Hepatitis B shots, and pneumococcal shots—these prevent some types of pneumonia and are generally only needed once in a lifetime. These services may be provided only to people with particular risk factors and/or only at particular times of year. Flu shots are covered once a year for all Medicare beneficiaries. Check with your plan to find out whether you are eligible for the other services.
Preventive care services covered by Medicare even include counseling to stop smoking for people who have not yet been diagnosed with a smoking-related illness. They also provide medical nutrition therapy services. Medicare covers a one-time "Welcome to Medicare" physical exam during which a doctor will review your current health status and provide you with educational materials about when you should schedule certain preventive health care services.
Medicare Advantage Plans may offer additional covered services and/or may offer the screenings on a more frequent basis. Some plans may offer extra "wellness" benefits that provide expanded coverage. Check with your individual Medicare Advantage Plan provider for details.
In addition to the numerous health benefits provided by preventive health care, many preventive care services will also save you money. Through prevention
and early detection, preventive care catches, treats, and manages medical issues before they become prohibitively expensive.
Medical expenses are a leading cause of worry for most Americans. By keeping up with your wellness exams and preventive screenings, you can help control your medical expenses. For additional details, contact your Medicare plan provider or visit www.Medicare.gov.
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