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2004-07-15 / Savvy Senior


Medicare Preventive Services
Dear Savvy Senior,
YOU ASK THE SENIOR QUESTION WE FIND THE SAVVY ANSWER Medicare Preventive Services Dear Savvy Senior,

WE FIND THE SAVVY ANSWER Medicare Preventive Services Dear Savvy Senior,

My husband and I have made our health a priority. We exercise regularly, eat right and remain trim. And as recommended, we go in for all the required visits and tests. So far we have been blessed with an insurance company smart enough to recognize the benefits of early screenings.

But I’ve learned that Medicare doesn’t cover annual visits to the doctor and I’m worried that when we hit 65 we’ll lose coverage for some of the routine screenings that are one of the corner stones for good health. What can you tell me about this? Is Medicare going to be there?

Screened in Scranton

Dear Screened,

Not to worry! While your annual physical will have to come out of your own pocket, Medicare will pick up the tab for some key preventive services that can help you stay healthy. Preventive health service on your body is like preventive maintenance on your car. It helps them both run better and last longer. That’s why Medicare is working to make it easier for its beneficiaries to get more preventive care services.

Here is a list of some of what’s paid for:

• Colorectal cancer screenings for all people with Medicare. Tests that are covered are: fecal occult blood test (once every 12 months), flexible sigmoidoscopy (once every 48 months), colonoscopy (every 24 months if you are at high risk or every 10 years if you are not), and barium enema (every 24 months if you are at high risk).

• Mammography for breast cancer screening, available to all women once every 12 months. Pap smears and pelvic examination for cervical cancer screening, available to all women and is covered every 24 months, unless you are at high risk and then it will pay for it once every 12 months.

• Prostate cancer screenings, available to all men every 12 months and includes the digital rectal exam and prostate specific antigen (PSA) tests.

• Diabetes self-management training, glucose monitors, test strips and lancets.

• Glaucoma testing done by a licensed eye doctor who is legally allowed to provided his service in your state, available every 12 months to people at high risk for the disease (diabetes, family history of glaucoma, African American).

• Flu and pneumonia shots, and Hepatitis B shots.

• Bone mass measurements to detect osteoporosis, available every 24 months. Talk to your doctor to see if you qualify.

The preventive services that are listed are covered by Medicare Part B, but not completely. Medicare, in most cases, will pay 80 percent, which means you’ll pay the other 20 percent of the approved amount (or a co-payment amount) after paying the Part B deductible. In some cases, however, the test may be fully covered.

Also, many of these preventive services are for people who are at high risk for the particular disease. As to what constitutes high risk is a medical assessment, that will have to be made by a doctor. But it usually takes into account your age, health and family history.

For more information on Medicare preventive services visit Medicare also offers a free publication called "Medicare Preventive Services To Keep You Healthy" (publication 10110). To order a copy, or for any questions call Medicare at 1-800-633-4227.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit Jim Miller is a regular contributor to the NBC Today Show and author of "The Savvy Senior" book.

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