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