Preventive Services for People with Medicare

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Medicare’s coverage provides you a one-time initial physical after you enroll. You’ll also receive screening tests for heart disease and diabetes. This article gives you more information about these services.

Initial Physical Exam

If your Medicare Part B coverage began on or after Jan. 1, 2005, you will receive a one-time initial, preventive physical exam, also called a "Welcome to Medicare" exam. The physical must occur within the first six months that you have coverage. The exam includes:

• An evaluation of your health
• Information about the preventive services you may need, including shots or screenings
• Referrals for additional care, if you need it

For any services your provider suggests, you have to pay 20 percent of the Medicare-approved amount. You also must satisfy your yearly Part B deductible.

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 describing the screenings and other preventive services you should get.

Be prepared for your exam. Bring the following items with you when you go:

• A list of prescription drugs that you currently take
• Medical records, especially if you are seeing a new doctor
• Family health history; any details you give your doctor can help determine if you are at risk for specific diseases

Screenings for Heart Disease and Diabetes

Medicare also covers screenings for heart disease, or cardiovascular screenings, which check your cholesterol level and other blood fat (lipid) levels. Medicare pays for these tests every five years. You do 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 your health, Medicare may pay for up to two screenings each year. Also, you will not have to pay coinsurance or the Part B deductible for this screening. Medicare may also cover certain supplies (for example, glucose testing monitors and strips) and training so that you can better manage self-administered treatments (for example, insulin shots).