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Annual Preventative Services for Beneficiaries

Annual services beneficiaries can use with no out of pocket cost (under Part B).

Preventative Checklist for Beneficiaries: https://www.medicare.gov/Pubs/pdf/11420-Preventive-Services-Card.pdf? 

  • Wellness Visit
    • Annual
    • Risk assessment
    • Height and weight a blood pressure
    • Detection of cognitive impairment
    • Risk factors and treatment options
  • Alcohol Misuse Screenings and Counselling
    • Screening once per year if you don’t meet the criteria for alcohol dependency
    • If primary care says you need it, you get 4 face-to-face counselling sessions per year
  • Colon Cancer Screening
    • Annual
    • Screening fecal occult blood test
    • If over the age of 50
  • Depression Screening
    • Annual
  • Diabetes Screening
    • Annual
    • If determined high risk
      • High Blood pressure
      • History of abnormal cholesterol and triglyceride levels (dyslipidemia)
      • Obesity
      • A history of high blood sugar
    • If to you more apply to you
      • 65+
      • Overweight
      • Family history (parents or sibling)
      • History of gestational diabetes
  • Hepatitis B Virus Screening
    • High Risk or Pregnant
    • Must be ordered by doctor
  • Hepatitis C Screening Test
    • ONE TIME if you meet one of the following criteria
    • risk because you use or have used illicit injection drugs.
      • You had a blood transfusion before 1992.
      • You were born between 1945-1965.
    • If “high risk”, Medicare will cover yearly
  • HIV Screening
    • Once per year if
      • You’re between the ages of 15-65
      • Your younger than 15, or older than 65 and you have an increased risk
      • If pregnant, can get it up to 3 times during your pregnancy
  • Lung Cancer Screening
    • With Low Dose Computer Tomography
    • Once per year if you meet all the below conditions
      • You’re age 55-77.
      • You don’t have signs or symptoms of lung cancer (asymptomatic).
      • You’re either a current smoker or have quit smoking within the last 15 years.
      • You have a tobacco smoking history of at least 30 “pack years” (an average of one pack (20 cigarettes) per day for 30 years).
      • You get a written order from your doctor.
  • Mammogram (screening)
    • Screening Mammogram covered annually
      • Diagnostic Mammogram is also covered, but the Part B co-insurance and deductible will apply
  • Nutrition Therapy Service
    • If you have diabetes, kidney disease, or a transplant in the last 36 months
    • Services may include:
      • An initial nutrition and lifestyle assessment
      • Individual and/or group nutritional therapy services
      • Help managing the lifestyle factors that affect your diabetes
      • Follow-up visits to check on your progress in managing your diet
  • Obesity Screenings and Counselling
    • IF you have a Body Mass Index (BMI) of 30 or more.
    • Initial screening for BMI and behavioral therapy sessions that include a dietary assessment and counseling to help you lose weight
  • Prostate Cancer Screenings
    • Once per year for men over 50
    • PSA Test covered annually
      • Digital rectal exam also covered, but Part B co-insurance and deductible will apply
  • Sexually Transmitted Infections Screening and Counselling
    • Medicare covers these tests once every 12 months or at certain times during pregnancy. Medicare covers behavioral counseling sessions once each year
    • Covered for chlamydia, gonorrhea, syphilis, and/or Hepatitis B is pregnant or at increased risk for STIs
    • Medicare also covers up to 2 individual 20-30 minute, face-to-face, high-intensity behavioral counseling sessions if you’re a sexually active adolescent or adult at increased risk for STIs.
  • Shots
    • Flu
      • Once per flu season
    • Hepatitis B
      • If one of these apply
      • You have hemophilia.
      • You have End-Stage Renal Disease (ESRD) .
      • You have diabetes.
      • You live with someone who has Hepatitis B.
      • You’re a health care worker and have frequent contact with blood or bodily fluids.
    • Pneumococcal Shots
      • Medicare Part B (Medical Insurance) covers 2 different pneumococcal shots. Part B covers the first shot at any time and a different, second shot if it’s given at least one year after the first shot.
  • Smoking and Tobacco-use Cessation counselling
    • Up to 8 visits of smoking and tobacco-use cessation counseling visits in a 12-month period smoking

 

Source: https://www.medicare.gov/coverage/preventive-screening-services

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