The Medicare Program offers preventive services that help beneficiaries stay healthy by improving access to early detection and disease prevention services. Educating beneficiaries about preventive services gives them control over their healthcare choices.^[1]

Why is prevention important?

Prevention is important in helping Medicare beneficiaries stay healthy, live longer and delay or prevent the onset of serious illnesses. Maintaining a healthy diet and exercising are just a part of prevention. Other factors include: avoiding smoking, maintaining a healthy weight, and managing existing diseases such as diabetes.^[1]

How can Medicare beneficiaries take advantage of preventive services?

Beneficiaries can get regular medical checkups, screening tests and vaccinations, all of which can help them stay healthy. When enrolling into Medicare for the first time after January 1, 2006, beneficiaries are offered a “Welcome to Medicare” physical exam. This exam educates Medicare beneficiaries about the preventive services offered by the Medicare program, includes a review of the beneficiary’s medical history, a vision test, an electrocardiogram and a written checklist of what other preventive screenings are necessary for the future. Beneficiaries are responsible for 20 percent of the “Welcome to Medicare” exam after meeting their yearly Part B deductible. Currently, the Part B deductible is $131 and can change annually.^[1]

How does Medicare serve beneficiaries with disabilities?

Of the 44 million beneficiaries enrolled in Medicare, approximately 7 million are affected by disabilities or long-term illnesses. Medicare provides coverage of routine, acute, or preventive care; rehabilitation, mental health, and home health services and medical equipment necessary for these beneficiaries to maintain their health and independence. Research has shown that individuals with disabilities are more likely to experience uncommon health conditions (e.g. urinary tract infections and pressure sores). These individuals also find it harder to properly manage their health after the onset of chronic illnesses.^[2] For these reasons, it is important for Medicare beneficiaries with disabilities to take advantage of the preventive services offered by Medicare to avoid expensive hospitalizations and adverse health outcomes.^[3]

What preventive services are offered by Medicare?

In addition to the “Welcome to Medicare” physical, exam, beneficiaries can take advantage of preventive services that include: diabetes screening, cardiovascular screening, cancer testing, influenza vaccinations, and smoking and tobacco cessation programs. For beneficiaries with certain risk factors, Medicare will also cover the cost of diabetes screenings. Early screening for diabetes can help prevent the onset of comorbidities such as cardiovascular and/or kidney disease. Medicare beneficiaries with risk factors such as high blood pressure, high cholesterol, obesity and a history of high blood sugar are eligible for two diabetes screenings per year.

To reduce the burden of cardiovascular disease, Medicare beneficiaries are able to receive free cardiovascular screening every 5 years that checks cholesterol levels. Covering routine cancer screenings is another benefit the Medicare program offers to its beneficiaries. Annual mammograms are offered to women over 40, annual prostate exams for men over 50, pelvic exams and pap tests for women, and colon cancer screening for beneficiaries over 50. Influenza vaccinations are offered to Medicare beneficiaries on a yearly basis to help prevent the onset of influenza and other health complications associated with the flu. For beneficiaries with a medium to high risk for hepatitis B, Medicare will cover the costs of a hepatitis vaccination. Medicare also covers glaucoma screening for beneficiaries with diabetes, a family history of glaucoma or Hispanic beneficiaries over the age of 65. Finally, Medicare provides coverage for smoking and tobacco cessation for individuals who have developed complications caused by tobacco use.^[1]

How do individuals figure out their eligibility for Medicare Preventive Services?

Individuals can find out more information about the Medicare Preventive Services program by visiting www.mymedicare.gov. This site allows them to create a personalized account that details their eligibility for specific benefits and keeps a track of what services have been utilized.^_[1]

^[1] CMS. Medicare Preventive Services to Keep You Healthy. CMS Publication #10110.

^[2] DeJong G, Sutton J. (1998). Managed Care and Catastrophic Injury: The Case of Spinal Cord Injury. Topics in Spinal Cord Injury Rehabilitation. 3(4): 1-16.

^[3] Kaiser Family Foundation. (2005). Navigating Medicare and Medicaid, 2005. A Resource Guide for People with Disabilities, Their Families, and Their Advocates. Accessed here