Your Health

Prevention is the first step to taking good care of yourself. Fortunately, Medicare pays for many preventive health services. Take advantage of all that Medicare has to offer, and talk to your doctor about scheduling preventive health screenings today. In addition to the following general screenings, there are also tests and screenings specifically for men and women.

“Welcome to Medicare” Physical Exam
When you join Part B, Medicare covers a one-time physical exam within the first six months after you have Part B. During the exam, your doctor will do a thorough review of your health and talk to you about getting other preventive services that you may need. Your doctor may check your vision, your heart, and make sure you’re up to date on all your shots.

Medicare will pay 80 percent of the “Welcome to Medicare” physical after you meet your Part B deductible. Since this may be your first visit after obtaining Part B, you may meet your entire deductible amount at this visit.

Cardiovascular Screening
Since high cholesterol contributes to many different heart problems, Medicare offers cholesterol and lipid screenings.

Medicare will cover these tests once every five years.

Colon Cancer Screening
The risk of getting colon cancer increases after you turn 50. Colon cancer screenings can detect early signs of cancer so that doctors can address symptoms before the condition becomes more serious.

Medicare covers a fecal occult blood test once per year, a flexible sigmoidoscopy once every four years, and a screening colonoscopy once every two years if you’re at high risk (once every 10 years if you’re not at high risk). Your doctor may substitute a barium enema for the flexible sigmoidoscopy or the colonoscopy.

Medicare will pay for 100 percent of the fecal occult blood test and 80 percent of all other tests after the yearly Part B deductible is met.

Vaccines
The flu can be a potentially serious sickness, because if it is not treated immediately and properly, it can progress into more serious conditions, such as pneumonia, which could require hospitalization.

Because of this, Medicare covers 100 percent of a flu shot once per year. Medicare also pays 100 percent of a pneumonia shot once in a lifetime.

Additionally, Medicare covers 80 percent of Hepatitis B shots (three shots are needed for protection) after the yearly Part B deductible is met. The Hepatitis B shots are available for those with Medicare considered at medium or high risk for Hepatitis B. Check with your doctor to see if you qualify.

Diabetes Screening, Supplies, and Self-Management Training
Diabetes is a serious medical condition in which your body doesn’t make enough insulin. It causes your blood sugar to be too high because insulin is needed to use sugar properly.

If you are at risk for getting diabetes, Medicare covers several preventive services that you should take advantage of. You are considered at risk for diabetes if you have:  high blood pressure, abnormal cholesterol, obesity, or a history of high blood sugar. Check with your doctor to find out for sure if you’re at risk for diabetes.

Medicare will cover 100 percent of a diabetes screening test. You may be able to get two of these screenings per year.

If you already have diabetes, Medicare will cover 80 percent of your diabetes supplies (glucose monitors, test strips, lancets) after the yearly Part B deductible is met.

Also, if you have diabetes and are at risk for complications, your doctor may ask that you attend diabetes self-management training. Medicare will cover 80 percent of the cost associated with this training after the yearly Part B deductible is met.

Glaucoma Tests
Glaucoma is an eye disease that is caused by pressure in the eye. If not treated, it can cause blindness.

You are at high risk for glaucoma if you have diabetes, if you have a family history of glaucoma, and/or if you are an African American aged 50 or older. If you are at high risk, Medicare will pay for 80 percent of regular eye exams to check for glaucoma, after the yearly Part B deductible is met.

Additional information is available!
Quality Insights of Pennsylvania is committed to helping Medicare consumers get information on the preventive services they need. We offer materials on mammograms, vaccines, and diabetes free of charge.

Items available include brochures on the signs and risks of breast cancer, diabetes management kits, and information on the flu and pneumonia vaccines. To view or order these free materials, use our online ordering system or call our toll-free resource hotline at 1-877-346-6180, extension 7697.

For free information on diabetes in Spanish, please visit the Web sites for the Pennsylvania Department of Health, the Centers for Disease Control and Prevention (CDC), and the National Diabetes Information Clearinghouse.