16 Free Medicare Services

 

“Good health and good sense are life’s greatest blessings.” This wise observation--offered by Roman writer Publilius Syrus more than 2,000 years ago--still rings true. If you are a senior or have been approved for Social Security disability benefits and are covered by Medicare, you can be proactive in improving your health by using your good sense to make the most of the free tests and services offered under a federal healthcare law.

The U.S. Department of Health and Human Services sums it up this way: “The best way to stay healthy is to live a healthy lifestyle. You can live a healthy lifestyle and prevent disease by exercising, eating well, keeping a healthy weight, and not smoking. Medicare can help. Medicare pays for many preventive services to keep you healthy.”

The Affordable Care Act (ACA) expanded access to free preventive care, and that included some important Medicare services. AARP says this includes two important medical exam offerings:

  1. “A ‘Welcome to Medicare’ preventive visit. This is available only in the first 12 months you are on Part B. It includes a review of your medical history, certain screenings and shots, measurements of vital signs, a simple vision test, review of potential risk for depression, an offer to discuss advance directives and a written plan outlining which screenings, shots and other preventive services you need. This visit is covered one time.
     
  2. Annual wellness visit. You’re eligible for this free exam if you’ve had Medicare Part B for longer than 12 months. The physician will review your medical history; update your list of providers and medications; measure your height, weight, blood pressure and other vital signs; and provide you with personalized health advice and treatment options. (Note: While this visit is free, the doctor may order other tests or procedures for which you might have a deductible or copay.)”

Kaiser Health News (writing in collaboration with the Washington Post) says the following 14 tests are available for free to Medicare beneficiaries—no co-payments, coinsurance or deductibles—when provided by health-care professionals who accept Medicare.

  1. Annual mammograms for women 40 and older. (“If you require a diagnostic mammogram, you’ll pay a 20 percent co-pay and the Part B deductible will apply,” AARP reports.)
  2. Cervical cancer screening, including a Pap smear test and pelvic exam, every two years or annually for women with a high risk of cervical cancer.
  3. Colorectal cancer screenings every 10 years, or every two if at high risk, for people 50 and older.
  4. Cholesterol test and other cardiovascular screenings every five years.
  5. Diabetes screening for people at risk for the disease.  (AARP adds that “you’re eligible for two free screenings each year if you have a history of high blood pressure, abnormal cholesterol levels, are obese or have a history of high blood sugar levels. The screenings will also be free if two or more of these issues apply to you: You are over 65, are overweight or have a family history of diabetes, or you had diabetes when you were pregnant.”)
  6. Medical nutrition counseling to help people manage diabetes or kidney disease (three hours of individual counseling the first year and then two hours annually).
  7. Obesity screening and counseling for those with a body mass index (BMI) of 30 or more.
  8. Annual prostate cancer screening (PSA test) for men 50 and older.
  9. Lung cancer screening once a year with Low Dose Computed Tomography (LDCT) for people are age 55-77 who are either a current smoker or have quit smoking within the last 15 years and have a tobacco smoking history of at least 30 “pack years” (an average of one pack a day for 30 years.) You must get a written order from your physician or qualified non-physician practitioner.
  10. Vaccines for influenza (annually), pneumonia (once) and hepatitis B for those at risk of the disease. (AARP notes that the shingles vaccine is not covered by Part A or Part B, but it may be covered by your Medicare Advantage (MA) plan or your Part D prescription drug plan.)
  11. Bone mass measurement every two years (more often if medically necessary) for people at risk of osteoporosis.
  12. Depression screening once a year. The screening must be done in a primary care setting (like a doctor’s office) that can provide follow up treatment and referrals.
  13. HIV screening for people who are at increased risk including anyone who asks for the screening.
  14. Smoking cessation counseling.

Jonathan Blum, deputy administrator at the Centers for Medicare and Medicaid Services says “Our hope is that by waiving cost-sharing and making preventive care more affordable, more beneficiaries will get it.”

For the list of Medicare’s free preventative services and additional information, get a copy of the “Medicare & You” handbook which is available for download by navigating to www.medicare.gov and then entering “Medicare and You” in the search box or by calling 800-MEDICARE.  A 48-page guide on preventive benefits is also available from Medicare at www.medicare.gov/Pubs/pdf/10110.pdf

Timothy J. Cuddigan
Omaha Social Security and Veterans Disability Lawyer With Over 40 Years Experience
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