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Health Insurance Basics

Medicare Members: Take Advantage of Your Covered Preventive Services

August 25, 2017

Preventive health care can help detect diseases early — when they’re easiest to treat. That’s good news for qualified Medicare beneficiaries, because many preventive services are covered by Medicare

Get the Preventive Benefits You’ve Earned, Including Annual Doctor Visits

It’s smart to take advantage of your Welcome to Medicare preventive visit.

  • Go see your doctor during the first 12 months of being a Medicare beneficiary with Part B coverage for this important preventive visit.
  • Your visit will include a review of both your medical and social history (as it relates to your health), plus education about services like recommended screenings, shots and referrals for other care if you need.

Qualified Medicare beneficiaries who’ve had Part B for at least a year can also get an annual wellness visit. When you set this appointment, be sure to let your doctor’s office know that it’s your yearly wellness visit, which is included in your Medicare coverage once every 12 months. During your visit, you can expect to fill out a Health Risk Assessment questionnaire and receive:

  • A review of your medical and family history.
  • Height, weight, blood pressure, and other routine measurements.
  • Detection of any cognitive impairment.
  • Personalized health advice.
  • A list of risk factors and treatment options for you.
  • A screening schedule (like a checklist) for appropriate preventive services.
  • The option to include an advance care planning discussion.

Keep in mind, you’re entitled to these preventive services — whether you get your benefits through Original Medicare (specifically Part B) or choose to get your benefits through a Medicare Advantage (Part C) from a private insurer.

What Other Preventive Care Is Covered At No Cost?

If you are considered at risk or otherwise eligible, Medicare covers 100% of its approved amount (with no Part B deductible) for all of these services:

  • Abdominal aortic aneurysm screening.
  • Alcohol misuse screening.
  • Bone mass measurement.
  • Breast cancer screening/mammogram.
  • Cervical and vaginal cancer screening.
  • Depression screening.
  • Diabetes screening.
  • EKG heart screening.
  • Flu shot.
  • Hepatitis B shots.
  • Hepatitis C screening.
  • HIV screening.
  • Laboratory services.
  • Lung cancer screening.
  • Medical nutrition therapy.
  • Obesity screening and counseling.
  • Pneumonia shots.

Medicare coverage also extends to these services, but with a few limitations:

  • Cardiovascular heart disease screening — screenings are free, but the doctor visit may require a copay.
  • Colon colorectal cancer screening — the colonoscopy test is free, but there may be a copay for polyp removal.
  • Glaucoma screening — 80% of the Medicare-approved amount is covered, after you pay the Part B deductible.
  • Prostate cancer screening — the PSA test is free with no Part B deductible; for a digital rectal exam, 80% of the Medicare-approved amount is covered after you pay the Part B deductible.
  • Sexually Transmitted Illness (STI) screening and counseling — free if your doctor orders tests and they are performed in a Medicare-approved lab.
  • Smoking cessation counseling — free for those who do not have a smoking-related illness; 80% covered for those who do.

Keep in mind, the Medicare-approved amount assumes your doctors and other providers accept it as payment in full, which is known as “assignment.” If you get your services from someone who doesn’t accept assignment, you might pay more. Even if you do, it can still be a great investment in your overall health.

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Anthem Blue Cross and Blue Shield is the trade name of: In Colorado: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. In Connecticut: Anthem Health Plans, Inc. In Indiana: Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Maine: Anthem Health Plans of Maine, Inc. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc., dba HMO Nevada. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. HMO plans are administered by Anthem Health Plans of New Hampshire, Inc. and underwritten by Matthew Thornton Health Plan, Inc. In Ohio: Community Insurance Company. In Virginia: Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield in Virginia, and its service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. Anthem Blue Cross and Blue Shield and its affiliate HealthKeepers, Inc. In Wisconsin: Blue Cross Blue Shield of Wisconsin (BCBSWi), underwrites or administers PPO and indemnity policies and underwrites the out of network benefits in POS policies offered by Compcare Health Services Insurance Corporation (Compcare) or Wisconsin Collaborative Insurance Corporation (WCIC). Compcare underwrites or administers HMO or POS policies; WCIC underwrites or administers Well Priority HMO or POS policies. Independent licensees of the Blue Cross and Blue Shield Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are the registered marks of the Blue Cross and Blue Shield Association.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or co- payments/co-insurance may change on January 1 of each year. You must continue to pay your Medicare Part B premium.

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