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Understanding Medicares Preventive Benefits… Stay informed…Stay healthy Brought to you by.

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Presentation on theme: "Understanding Medicares Preventive Benefits… Stay informed…Stay healthy Brought to you by."— Presentation transcript:

1 Understanding Medicares Preventive Benefits… Stay informed…Stay healthy Brought to you by

2 2 Session Topics What is Covered –Eligibility –Risk factors –What you pay –Why it is important Information Sources Question and Answer

3 3 Healthy Lifestyle Diet Exercise Maintain a Healthy Weight Healthy Choices (Don't Smoke) Take advantage of preventive services!

4 4 Most recent additions! Ultrasound screening for abdominal aortic aneurysms –Referred to during Welcome to Medicare exam –No deductible Smoking cessation coverage No deductible for colorectal cancer screening

5 5 Bone Density Measurement For people at risk for osteoporosis Age 50+ Female Family or Personal History of Broken Bones White or Asian Small boned Low body weight (under 127 lbs.) Smoke, drink a lot of alcohol Low calcium diet Eligibility Risk Factors

6 6 Bone Density Measurement Bone Mass Measurement once every two years You Pay: 20% after Part B Deductible What it covers What you pay

7 7 Colorectal Cancer Screening For all people with Medicare age 50 and older Close relative with colorectal cancer History of polyps Diet high in fat, Smoking, drinking Overweight Risk increases with age Eligibility Risk Factors

8 8 Colorectal Cancer screening Fecal Occult blood test Flexible Sigmoidoscopy Colonoscopy –No age limit for those at high risk Barium Enema Nothing for Fecal Occult test 20% for all other tests-no deductible 25% colonoscopy done in hospital What it covers What you pay

9 9 Diabetes Screening All people at risk High Blood pressure High Cholesterol Obesity History of high blood sugar At least 2 of the following –65+ –Overweight –Family history –History of gestational diabetes or delivering a baby over 9 lbs. Eligibility Risk Factors

10 10 Diabetes Screening Fasting blood glucose test-up to twice in a 12 month period Self Management Training Medical Nutrition Therapy Blood Sugar testing supplies Special Eye Exams Hemoglobin A1c tests For people with Diabetes who need them: Insulin Pumps Special Foot Care Therapeutic Shoes What it covers What you pay Additional Covered Services No co-payment or deductible in Original Medicare

11 11 Screening Mammograms Age one baseline once a year starting at age 40 Risk Factors: –Family history –First baby after age 30 or never had a baby –HRT for a long time –Overweight Check for abnormal breast tissue using new digital technology Eligibility Risk Factors What it covers

12 12 Screening Mammograms 20% coinsurance –no deductible Most commonly diagnosed non-skin cancer in women and leading cause of cancer death for women in U.S. Often successfully treated when found early What you pay Why Important

13 13 Pap Test and Pelvic Exam High Risk for Vaginal Cancer Mother took DES when pregnant with you Childbearing age and had an abnormal Pap test in past 36 months All women on Medicare Eligibility Risk Factors

14 14 Pap Test and Pelvic Exam You Pay: Nothing for the Pap Lab Test –20% for Pap Test collection, pelvic exam/clinical breast exam-No Part B Deductible Once every 24 months but, every12 months if… High Risk for cervical cancer –Abnormal Pap Test –Infected with HPV –Sex before age 16 –Many sexual partners –No negative or had any Pap Tests in past 7 years What you pay What it covers

15 15 Prostrate Cancer Screening All men with Medicare age 50+ Age Heredity Covers: –Digital Rectal Exam –PSA Blood Test 20% after Part B Deductible for the digital rectal exam Nothing for the PSA Blood test Eligibility Risk Factors What it covers What you pay

16 16 Flu Shot All people with Medicare Risk Factors: –Can Lead to pneumonia –Dangerous viral illness for people age 50+ One shot each flu season Nothing Eligibility Risk Factors What it covers What you pay

17 17 Pneumonia Vaccination All people with Medicare One shot is usually all you will ever need Nothing Eligibility What it covers What you pay

18 18 Hepatitis B Hepatitis B shots Covered for those at medium to high risk for End-Stage renal disease or Hemophilia or conditions that lower resistance to infection You Pay: 20% after Part B Deductible Serious disease that can cause liver failure or death Eligibility & Risk Factors What you pay Why it's important What is covered

19 19 Glaucoma All Medicare Beneficiaries Family history of glaucoma Diabetes African Americans age 50+ Hispanic Americans age 65 Screening eye exam every 12 months 20% after Part B Deductible Eligibility Risk Factors What it covers What you pay

20 20 Cardiovascular Disease Screening All Medicare beneficiaries Blood tests for early detection of heart disease-Every 5 yrs –Cholesteral –Trigylcerides –Lipids No copayment or deductible in Original Medicare Eligibility What is covers What you pay

21 21 Welcome to Medicare Physical One time physical for all beneficiaries who begin with Medicare 1/1/2005 and after and get the exam within the first six months of Part B coverage Height, weight, blood pressure, EKG, education and counseling and referrals i.e. Ultrasound for abdominal aneurysm 20% after the Part B deductible is met Eligibility What it covers What you pay

22 22 Smoking Cessation Covered for those with an illness caused or complicated by tobacco use and or who take medication affected by tobacco use Cessation counseling up to 8 sessions per year. Drug therapies e.g. nicotine patches 20% after Part B deductible Significant health benefits for those who quit Eligibility What it covers What you pay Why it's important

23 23 If you want to know more Medicare or American Cancer Society or Centers for Disease Control and Prevention

24 24 Key Concepts You can take steps to live a longer and healthier life Take advantage of Medicare preventive services Information is available –Internet –Publications –1-800-MEDICARE


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