Preventive Care Under Medicare
Medicare covers preventive care services when you have an on-going health care problem that requires that your doctor order these tests. You may be required to pay a portion of the costs for these services. Your Medicare handbook provides more details regarding these costs. Medicare defines the following as preventive care and covers some of these services.
Bone mass measurement—Medicare provides coverage if you are at risk for losing bone mass. You are required to pay the annual Part B deductible before this benefit is payable.
Cardiovascular disease screening—Medicare provides coverage for a screening blood test for early detection of cardiovascular (heart) disease. Medicare pays for this benefit whether you have met your Part B deductible or not.
Colorectal cancer screening—Medicare provides coverage for those tests that your doctor determines are appropriate. You are required to pay the annual Part B deductible based on limitations established by Medicare regarding frequency, age requirements, and the specific test involved.
Diabetes monitoring—Medicare provides coverage if you have diabetes whether or not you use insulin. Medicare covers lancets, test strips, self-management training, and one blood glucose monitor based on the recommendation of your doctor. You are required to pay the annual Part B deductible before this benefit is payable.
Diabetes screenings—Medicare provides coverage for screening if your doctor determines you are at risk for getting diabetes. Medicare pays for this benefit whether you have met your Part B deductible or not.
Flu shot—Medicare provides coverage for a flu shot once a year. Medicare pays for this benefit whether you have met your Part B deductible or not.
Glaucoma tests—Medicare provides coverage for glaucoma screening once a year if you have diabetes or a family history of glaucoma. You are required to pay the annual Part B deductible before this benefit is payable.
Hepatitis B tests—Medicare provides coverage when your doctor recommends vaccination based on an intermediate or high risk. You are required to pay the annual Part B deductible before this benefit is payable.
Mammogram screening—Medicare provides coverage for a mammogram once a year for all women age 40 and over who are covered under Medicare. Medicare pays for this benefit whether you have met your Part B deductible or not.
Pap test, pelvic exam, and clinical breast exam—Medicare provides coverage for one exam every 24 months. If you are a high-risk woman, Medicare covers one exam annually. Medicare pays for this benefit whether you have met your Part B deductible or not.
Pneumonia shot—Medicare provides coverage when your doctor recommends a shot that prevents pneumonia. Medicare pays for this benefit whether you have met your Part B deductible or not.
Prostate cancer screening—Medicare provides coverage for a screening once a year for all men age 50 and over who are covered under Medicare. You are required to pay the annual Part B deductible before this benefit is payable; however, prostrate specific antigen (PSA) tests are not subject to the deductible.
Smoking cessation (counseling to stop smoking)—Medicare provides coverage at any provider site if ordered by your doctor. It includes up to eight face-to-face visits during a 12-month period if you are diagnosed with a smoking-related illness or are taking medicine that may be affected by tobacco.
Wellness physical exam—Medicare provides coverage for a one-time initial wellness physical exam within six months of the day you first enroll in the Medicare program. You are required to pay the annual Part B deductible before this benefit is payable.