Many people are not aware that Medicare covers the following:
One-time “Welcome to Medicare” Physical Exam Beginning January 1, 2005, Medicare covers a one-time review of your health, as well as education and counseling about the preventive services you need, including certain screenings and shots. Referrals for other care if you need it will also be covered. You must have the exam within the first six months you have Medicare Part B. Due to changes by the Affordable Care Act, Medicare now covers Annual Wellness exams as well.
Cardiovascular Screenings Ask your doctor to test your cholesterol, lipid and triglyceride levels so he or she can help you prevent a heart attack or stroke. Beginning January 1, 2005, Medicare covers tests for cholesterol, lipid, and triglyceride levels every five years.
Screening Mammograms These tests check for breast cancer before you or your doctor may be able to feel it. Medicare covers mammograms once every 12 months for all women with Medicare age 40 and older.
Pap Test and Pelvic Exam (includes clinical breast exam) These exams check for cervical and vaginal cancers. Medicare covers these exams every 24 months for all women with Medicare and once every 12 months for women with Medicare at high risk.
Colorectal Cancer Screening These tests help find colorectal cancer early, when treatment is most effective. If you are age 50 or older, or are at high risk for colorectal cancer, one or more of the following tests is covered: Fecal Occult Blood Test, Flexible Sigmoidoscopy, Screening colonoscopy, and/or barium enema. How often Medicare pays for these tests is different depending on the test you and your doctor decide is best and your level of risk for this cancer.
Flu Shots These shots help prevent influenza, or flu virus. Medicare covers these shots once a flu season in the fall or winter for all people with Medicare.
Prostate Cancer Screening These tests help find prostate cancer. Medicare covers a digital rectal exam and Prostate Specific Antigen (PSA) test once every 12 months for all men with Medicare over age 50.
Pneumococcal Shot This shot helps prevent pneumococcal infections. Medicare covers this shot for all people with Medicare. Most people only need this shot once in their lifetime. Talk with your doctor.
Hepatitis B Shots These three shots help protect people from getting Hepatitis B. Medicare covers these shots for people with Medicare at high or medium risk for Hepatitis B.
Bone Mass Measurements These measurements help determine if you are at risk for broken bones. Medicare covers these measurements once every 24 months (more often if medically necessary) for people with Medicare at risk for osteoporosis.
Diabetes Screenings Beginning January 1, 2005, Medicare covers tests to check for diabetes. These tests are available if you have any of the following risk factors: high blood pressure, dyslipidemia (history of abnormal cholesterol and triglyceride levels), obesity, or a history of high blood sugar. Medicare also covers these tests if you have two or more of the following characteristics:
- age 65 or older
- family history of diabetes (parents, brothers, sisters)
- a history of gestational diabetes (diabetes during pregnancy) or delivery of a baby weighing more than 9 pounds.
Based on the results of these tests, you may be eligible for up to two diabetes screenings every year. Talk to your doctor for more information.
Glaucoma Tests These tests help find the eye disease glaucoma. Medicare covers these tests once every 12 months for people with Medicare at high risk for glaucoma.
For some of these services, you might have to pay a deductible, coinsurance and/or copayment. These amounts vary depending on the type of services you need and the kind of Medicare health plan you have.