New Preventative Services for People with Medicare: The New Medicare Prescription Drug Coverage
By: Source: AARP.org Date Posted: 2005-09-29 13:04:00-04:00
As of January 1, 2005, Medicare expanded coverage for some preventive services. These included a one-time initial physical exam after enrolling in Medicare and screening tests for heart disease and diabetes. Here is some additional information about these services.
Initial Physical Exam
If your Medicare Part B coverage began on or after January 1, 2005, Medicare will cover a one-time initial preventive physical exam, also called a "Welcome to Medicare" exam. This exam must occur within the first six months that you have coverage. The exam will include an evaluation of your health, information about the preventative services you may need (i.e. shots or screenings) and, if you need it, referrals for additional care. You will need to pay 20% of the Medicare-approved amount after your yearly Part B deductible for this service.
During the exam, your doctor will review your medical history and check your blood pressure, height, and weight. Your doctor may also give you a vision test and an electrocardiogram, a test that records the electrical activity of the heart. Your doctor will also make sure that you are up to date with all your shots. In addition, your doctor will give you information to help you prevent disease and maintain or improve your health. If you need additional services, you will get a written plan so that you know which screenings and other preventative services you should get.
Be prepared for your exam. Bring the following items with you at your visit:
- list of prescription drugs that you currently take
- medical records (if you are seeing a new doctor)
- family health history information — any details you can give your doctor who can help determine if you are at risk for specific diseases
Screenings for Heart Disease and Diabetes
Medicare now covers screenings for heart disease, also known as cardiovascular screenings, which check your cholesterol level and other blood fat (lipid) levels. Medicare will pay for theses tests every five years. You will not have to pay coinsurance or the Part B deductible for this screening.
If you are at risk for getting diabetes, Medicare also covers a blood sugar screening to check for diabetes. You are considered at risk if you have any of the following: high blood pressure, dyslipidemia (history of abnormal cholesterol and triglyceride levels), obesity, or a history of high blood sugar. Depending on you health, Medicare may pay for up to two screenings each year. Also, you will not have to pay co-insurance or the Part B deductible for this screening. Medicare may also cover certain supplies (i.e. glucose testing monitors and strips) and training so that you can better manage self-administered treatments (i.e. insulin shots).
Medicare will soon offer insurance coverage to help people pay for prescription drugs. The new program, known as Medicare Part D, will start January 1, 2006. To help you understand this new benefit, AARP has two basic publications: "What You Need to Know: The New Medicare Prescription Drug Coverage," and "Extra Help for People With Limited Income: The New Medicare Prescription Drug Coverage," and a series of supplemental facts sheets that provide more in depth information about the new benefit. "New Preventative Services for People with Medicare: The New Medicare Prescription Drug Coverage" is one of these fact sheets.
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