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The Importance of Preventive Care and Screening Services

Like most insurers, Medicare covers a wide variety of preventive care and screening services. Preventative care benefits both the insured, and the insurer. For the insured, screenings can help detect health concerns early while they are more easily treatable and less expensive to address. Similarly, insurers benefit from the reduced cost of treatments, especially when emergency treatments or costly hospital stays are avoided.

Here’s an example using dental care: A slight toothache addressed immediately usually requires no more than a filling. If that same toothache remains for a longer period of time, you may be looking at a root canal, a tooth extraction, or a crown – all of which are far more expensive for both the insurer and insured.

Preventive Care Overview

Medicare Part B covers preventive care services designed to help you maintain current health levels and, with your doctor’s guidance, improve your overall health. During preventive care appointments, your doctor may identify potentially serious conditions when they’re easier to treat. Your first wellness visit provides a baseline reading of your current health.

Your yearly wellness visit is vital in managing your health. During this appointment, your physician reviews your medical history and documents your vital signs, including:

  • Height
  • Weight
  • Blood pressure
  • Body mass index
  • Vision capabilities

During your first 12 months on Medicare, you will schedule a “Welcome to Medicare” preventive visit. Your doctor discusses your current state of health and makes recommendations regarding your medical needs. Ask questions to understand why your doctor makes these recommendations and determine if Medicare covers the recommended treatment, since your doctor may prescribe procedures outside your Medicare coverage.

After the first 12 months, you continue receiving yearly wellness exams. Medicare Part B covers these visits as long as 11 full months pass between each wellness appointment.

Other Preventive Care Services

Beyond your yearly wellness exam, Medicare covers a variety of preventive care services for eligible patients. Discuss each service with your healthcare provider to determine coverage.

For example some plans may offer diabetes self-management training that helps patients at risk for complications due to diabetes. Participants learn healthy lifestyle habits and diabetes management techniques to reduce risk. Diabetics and people with kidney disease may be eligible for nutrition therapy services to help manage their diet.

People with a body mass index greater than 30 may receive obesity screening and counseling. If your doctor feels you may misuse alcohol, you may be eligible for alcohol misuse counseling, while smokers may take advantage of smoking cessation counseling. Finally, preventive care shots for flu, pneumonia, and hepatitis B are available for qualified Plan B recipients.

Screenings

Screenings allow your physician to diagnose certain diseases even before serious symptoms manifest. While reviewing your medical history and “Health Risk Assessment” during your annual wellness visit, your physician may determine certain tests or screenings are in order. Be sure to check with your healthcare and Medicare providers to determine eligibility, but some of the screenings Medicare Part B covers include:

  • Diabetes
  • Depression
  • Numerous cancers, such as cervical, lung, and prostate
  • Hepatitis C
  • Mammograms

Conclusion

Preventive care begins with your Welcome to Medicare visit, where your physician establishes your baseline health status and makes any recommendations he or she deems necessary. It does not end there, however. Schedule a yearly wellness visit to monitor your health. Finally, implement any lifestyle changes your doctor recommends for not only lower medical costs but also greater health and improved quality of life.

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