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Clients often ask us for help with Medicare planning. The rules can be confusing, and making assumptions can be costly. Cardan Capital Partners Co-Founding Partner Marti Awad recently teamed with Carol Janz Booth of Group Insurance Analysts Inc., to share some tips to help you make proactive choices when it comes to your Medicare coverage.

How wise and prophetic Ben Franklin’s quote was in the 1700’s. Currently, there are a plethora of articles, blogs and newsfeeds on prevention and wellness road maps to health, including a couple that caught our attention on becoming a “cognitive super-ager”.  See Cognitive super agers defy typical age-related decline in brainpower and The Secrets of ‘Cognitive Super-Agers’.

The goal of this article is to clarify which preventive services and tests are covered under Medicare so you may chart your personal course to wellness. Medicare preventive services include exams, shots, lab tests and screenings including programs for health monitoring, counseling, and education.

Ms. Janz Booth is a Licensed Colorado Health Broker, Senior Health Plan Specialist and Certified Gerontologist

Medicare Part B (Medicare Insurance) covers many preventive services.  The first step is to talk to your doctor or health care provider to find out which preventive services are appropriate for you, and how often you should have them done. A comprehensive list of Preventive Services can be found on medicare.gov and includes 23 categories of services and is excerpted below.   You will find guidelines on:  “Who’s covered”, “How often is it covered” “What’s covered”, “Who is at risk” and “Your cost if you have Original Medicare”.

“From A-Z” list of preventive and screening services:

If you are enrolled, Medicare Part B (Medical Insurance) may cover:

  • Abdominal aortic aneurysm screening – IF you are at risk (family history, male 65 -75 and smoked at least 100 cigarettes in your lifetime), Medicare covers this once in your lifetime ultrasound with a referral from your doctor.
  • Alcohol misuse screenings & counseling
  • Bone mass measurements (bone density) – every 24 months (more often if medically necessary)
  • Cardiovascular disease screenings (Cholesterol tests are covered every 5 years unless your doctor orders it more frequently)
  • Cervical & vaginal cancer screening
  • Colorectal cancer screenings
    • Multi-target stool DNA tests
    • Screening barium enemas
    • Screening colonoscopies
    • Screening fecal occult blood tests
    • Screening flexible sigmoidoscopies
    • *If a polyp or other tissue is found and removed during the colonoscopy, you may be responsible for 20% of the Medicare-approved amount for the doctor’s services and a copay for the hospital or out-patient setting.  Your Medicare plan may cover these costs so investigate before scheduling so there are no surprises.
Marti Awad, CFA, CFP®, JD, LLM in taxation and Founding Partner of Cardan Capital Partners

Marti Awad, CFA, CFP®, JD, LLM in Taxation and Founding Partner of Cardan Capital Partners

  • Depression screenings
  • Diabetes screenings
  • Diabetes self-management training 
  • Flu shots
  • Glaucoma tests
  • Hepatitis B shots
  • Hepatitis B Virus (HBV) infection screening 
  • Hepatitis C screening test
  • HIV screening
  • Lung cancer screening
  • Mammograms (screening)
  • Nutrition therapy services
  • Obesity screenings & counseling
  • One-time “Welcome to Medicare” preventive visit – medical and social histories, your diet and activity level are discussed. Vitals are checked, BMI measured, baseline EEG, simple vision test, depression and safety risk surveys recorded and advance directives discussed. This is NOT a full physical.
  • Prostate cancer screenings
  • Sexually transmitted infections screening & counseling
  • Shots:
    • COVID-19 vaccines
    • Flu shots
    • Hepatitis B shots
    • Pneumococcal shots
    • ***Shingles vaccines ARE NOT covered as a preventive service currently but covered under Medicare Part D.  You must understand your Part D deductible and cost sharing before getting immunized. Part D also covers commercially available vaccines to prevent illness like Tdap – tetanus, diphtheria and pertussis.
  • Tobacco use cessation counseling
  • Yearly “Wellness” visit” – you don’t need to have had a “Welcome to Medicare” preventive visit before getting a yearly “Wellness” visit.  If you get the “Welcome to Medicare “preventive during your first year with Part B, you’ll have to wait 12 months before you can get your first yearly “Wellness” visit.

We suggest you register at mymedicare.gov to track your preventive health information, get a 2-year calendar of Medicare-covered tests and screenings you’re eligible for, and print a personalized “on-the-go” report to take to your next doctor’s appointment.

You may also peruse the services on medicare.govIs my test, item or service covered?  

The recent pandemic put many individuals behind in their routine screenings.  Get back on track with the screenings you may have fallen behind on your health and wellness journey. Physical health and mental health screenings, safety and functional mobility screenings, cancer screening and vaccinations are just one dimension of senior wellness.

Smart technology, alternative wellness techniques like holistic care, lifelong learning, exercise led by instructors and technology, food and nutrition education focusing on ‘gut” health, are just a few current wellness trends in the aging communities.  Physical and emotional health include ancient practices like yoga and tai chi.  Mindfulness and meditation have also been shown to have a positive effect on chronic pain.

Live well, be well and be proactive with preventive services under your Medicare benefits.

 

The content contained in this article is meant for educational purposes and is not an endorsement of Group Insurance Analysts Inc. Information presented is not meant to be a complete discussion of Medicare, Medicare Part D, nor plan-specific benefits. All expressions of opinion are as of its publishing date and are subject to change.

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