Medicare's Preventive Services

7/27/2019 Medicare's Preventive Services

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C E N T E R S F O R M E D I C A R E & M E D I C A I D S E R V I C E S

This is the official government

booklet with important information

about:

What disease prevention is and why its

important

Which preventive services Medicare

covers and how often

Who can get services

What you pay you pay nothing for

many services

Your Guide to Medicares

Preventive Services


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Y O U R G U I D E T O M E D I C A R E S P R E V E N T I V E S E R V I C E S

Nows the time to get the most out o your Medicare. Te best way to stayhealthy is to live a healthy liestyle. You can live a healthy liestyle and preventdisease by exercising, eating well, keeping a healthy weight, and not smoking.Medicare can help. Medicare pays or many preventive services to keep you healthy.Preventive services can find health problems early, when treatment works best, andcan keep you rom getting certain diseases. Preventive services include exams, shots,lab tests, and screenings. Tey also include programs or health monitoring, andcounseling and education to help you take care o your own health.

Te Affordable Care Act makes many improvements to Medicare. I you haveOriginal Medicare, you can get a yearly Wellness visit and many other coveredpreventive services.

Whether its online, in person, or on the phone, Medicare is committed to helpingpeople get the inormation they need to make smart choices about their Medicarebenefits.

MyMedicare.gov

Visit www.MyMedicare.gov toget direct access to your preventive healthinormation24 hours a day, every day. You can track your preventive services, get a2-year calendar o the Medicare-covered tests and screenings youre eligible or, andprint a personalized on the go report to take to your next doctors appointment.Visit the website, and sign up, and Medicare will send you a password to your

personal Medicare inormation.

How can this booklet help me?

Tis booklet covers preventive services, and services that help keep certain illnessesrom getting worse. Te services listed in this booklet are covered i you haveMedicare Part B (Medical Insurance). However, the amount you pay or theseservices varies depending on whether you get your Medicare benefits throughOriginal Medicare or through a Medicare Advantage Plan (like an HMO or PPO).Tis booklet explains the way preventive services are covered i you have Part B

under Original Medicare. I you get your health care coverage through a MedicareAdvantage Plan, call your plan or more inormation.

Note:Te inormation in this booklet was correct when it was printed. Changesmay occur afer printing. Visit www.medicare.gov orcall 1-800-MEDICARE(1-800-633-4227) to get the most current inormation. Y users should call1-877-486-2048.
http://www.mymedicare.gov/http://www.medicare.gov/http://www.medicare.gov/http://www.mymedicare.gov/


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3

Table of Contents

Section: 1 I n t r o d u c t i o n . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5What can I do to help prevent illness? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5alk to your doctor or health care provider . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

hings to know when reading this booklet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

Preventive Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

Alcohol misuse screening and counseling. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

Bone mass measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Breast cancer screening (mammograms) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

Cardiovascular disease (behavioral therapy) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

Cardiovascular disease screening . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

Cervical and vaginal cancer screening . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

Colorectal cancer screening . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

Depression screening . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

Diabetes screening and sel-management training . . . . . . . . . . . . . . . . . . . . . . 15

Glaucoma tests . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

HIV screening . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

Medical nutrition therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

Obesity screening and counseling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

Prostate cancer screening . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

Sexually transmitted inections screening and counseling . . . . . . . . . . . . . . . . 21

Shots (lu, pneumococcal, Hepatitis B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

obacco use cessation counseling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24

Welcome to Medicare preventive visit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

Yearly Wellness visit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

Preventive services checklist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

I n d e x . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 9

Section: 2

Section: 3


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4


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5

SECION

Introduction

What can I do to help prevent illness?

You can stay healthy, live longer, and delay or prevent many diseasesby:

ExercisingDo any physical activity you enjoy or 2030 minutes, 5 or6 days a week. alk to your doctor about the right exercise program oryou.

Eating wellEat a healthy diet o different oods, like ruits,vegetables, protein (like meat, fish, or beans), and whole grains (like

brown rice). You should also limit the amount o saturated at you eat.

Keeping a healthy weightWatch your portions, and try to balance thenumber o calories you eat with the number you burn by exercising.

Not smokingI you smoke, talk with your doctor about getting helpto quit.

Getting preventive servicesDelay or lessen the effects o diseases bygetting preventive services (like screening tests) to find disease early,and shots to keep you rom getting dangerous illnesses.

1

RememberThe

services listed in

this booklet are

covered if you

have Medicare

Part B (Medical

Insurance).


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6 Section 1:Introduction

Talk to your doctor or health care provider

In providing good care, your doctor or health care provider may do exams

or tests that Medicare doesnt cover. Your doctor or health care provider alsomay recommend that you have tests more or less ofen than Medicare coversthem. Medicare also pays or some diagnostic tests. A diagnostic test may berecommended when a screening test or exam shows an abnormality.In some cases, you may have to pay or these services.

alk to your doctor or health care provider to find out how ofen you need theseexams to stay healthy. I a service you get isnt covered and you think it should be,you may appeal this decision. o file an appeal, ollow the instructions on yourMedicare Summary Notice (MSN). Te MSN is an easy-to-read statement that

clearly lists your health insurance claims inormation. For more inormation onfiling an appeal, visit www.medicare.gov/appeals, orcall 1-800-MEDICARE(1-800-633-4227). Y users should call 1-877-486-2048.

Things to know when reading this booklet

Symbols

Youll see one o these symbols next to each preventive service. It tells you orwhom Medicare covers the service or test.

Men only Women only Men and Women
http://www.medicare.gov/appealshttp://www.medicare.gov/appeals


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7Section 1:Introduction

Things to know when reading this booklet (continued)

Risk factors

Youll also see lists o actors that increase your risk o developing a certaindisease. I youre not sure i youre at high risk, talk to your doctor.

Part B deductible

Te Part B deductible in 2013 is $147. Tis amount may change yearly.

Medicare-approved amount

In Original Medicare, this is the amount a doctor or supplier can be paid,including what Medicare pays, and any deductible, coinsurance, or copaymentthat you pay. It may be less than the actual amount a doctor or supplier charges.

Doctors and suppliers who accept assignment accept the Medicare-approvedamount as payment in ull. I you get your services rom a doctor or supplierwho doesnt accept assignment, you might pay more.

Drug coverage

Medicare Part D covers prescription drugs that may help you treat a disease orcondition ound by preventive screening tests, like high cholesterol. You canreview and compare the cost, coverage, and customer service o Medicare drugplans by visiting www.medicare.gov. Generally, you can join a Medicare drug planbetween October 15December 7. Your coverage will begin on January 1 o the

ollowing year. You can get personalized help by visiting www.medicare.gov, orbycalling 1-800-MEDICARE (1-800-633-4227). Y users should call1-877-486-2048.
http://www.medicare.gov/http://www.medicare.gov/http://www.medicare.gov/http://www.medicare.gov/


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8 Section 1:Introduction

Notes


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9

Preventive Services

SECION

Alcohol misuse screening and counseling

Whos covered?

Adults with Medicare (including pregnant women) who use alcohol, butdont meet the medical criteria or alcohol dependency.

How often is it covered?

Medicare covers one alcohol misuse screening per year. I your primarycare doctor or other primary care practitioner determines youre misusingalcohol, you can get up to 4 brie ace-to-ace counseling sessions per year(i youre competent and alert during counseling). A qualified primary caredoctor or other primary care practitioner must provide the counseling in aprimary care setting (like a doctors office).

Your costs if you have Original Medicare

You pay nothing i the qualified primary care doctor or other primary care

practitioner accepts assignment.

PS

2

RememberThe

services listed in

this booklet are

covered if you

have Medicare

Part B (Medical

Insurance).


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10 Section 2:Preventive Services

Bone mass measurements

Medicare covers bone mass measurements to see i youre at risk or

broken bones. People are at risk or broken bones because o osteoporosis.Osteoporosis is a disease in which your bones become weak and brittle.In general, the lower your bone density, the higher your risk or a racture.Bone mass measurement test results will help you and your doctor choose thebest way to keep your bones strong.

Who is covered?

Bone mass measurements are covered i medically necessary or certain peoplewith Medicare whose doctors say theyre at risk or osteoporosis, and have oneo these medical conditions:

A woman whose doctor or health care provider says shes estrogen-deficientand at risk or osteoporosis, based on her medical history and other findings

A person with vertebral abnormalities as demonstrated by an X-ray

A person receiving steroid treatments

A person with hyperparathyroidism

A person taking an osteoporosis drug


Once every 24 months (more ofen i medically necessary).


You pay nothing or this test i your doctor accepts assignment.

PS


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11Section 2: Preventive Services

Breast cancer screening (mammograms)

Breast cancer is the most common non-skin cancer in women and

the second leading cause o cancer death in women in the U. S. Everywoman is at risk, and this risk increases with age. Breast cancer usuallycan be successully treated when ound early. Medicare covers screeningmammograms and digital technologies to check or breast cancer beore youor a doctor may be able to find it manually.

Whos covered?

Women 40 and older are eligible or a screening mammogram every 12months. Medicare also covers one baseline mammogram or women between3539.


Once every 12 months.


You pay nothing or the test i the doctor accepts assignment.

Am I at high risk for breast cancer?

Your risk o developing breast cancer increases i any o these

are true: You had breast cancer in the past.

You have a amily history o breast cancer (like a mother, sister, daughter,or 2 or more close relatives who have had breast cancer).

You had your first baby afer age 30.

Youve never had a baby.

PS


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Cardiovascular disease (behavioral therapy)

Whos covered?

All people with Medicare.

Whats covered?

A cardiovascular disease risk reduction visit that includes:

Encouraging aspirin use when benefits outweigh risks

Screening or high blood pressure

Counseling to promote a healthy diet

How often is it covered?Once each year.


You pay nothing i your doctor or health care provider accepts assignment.

Cardiovascular disease screening

Medicare covers cardiovascular disease screenings that check your cholesteroland other blood at (lipid) levels. High levels o cholesterol can increase your

risk or heart disease and stroke. Tese screenings will tell i you have highcholesterol.

Whos covered?


Whats covered?

ests or cholesterol, lipid, and triglyceride levels.


Once every 5 years.


You pay nothing or this screening.

PS

PS


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13Section 2:Preventive Services

Cervical and vaginal cancer screening

Medicare covers Pap tests and pelvic exams to check or cervical and vaginal

cancers. As part o the pelvic exam, Medicare also covers a clinical breastexam to check or breast cancer.

Whos covered?

All women with Medicare.


Medicare covers these screening tests once every 24 months, or once every 12months or women at high risk, and or women o child-bearing age who have

had an exam that indicated cancer or other abnormalities in the past 3 years.


You pay nothing or Pap test. You pay nothing or the pelvic exam (includinga clinical breast exam) i the doctor accepts assignment.

Am I at high risk for cervical cancer?

Your risk or cervical cancer increases i any o these are true:

Youve had an abnormal Pap test.

Youve had cervical or vaginal cancer in the past. You have a history o sexually transmitted disease (including HIV

inection).

You began having sex beore age 16.

Youve had 5 or more sexual partners.

Your mother took DES (Diethylstilbestrol), a hormonal drug, when shewas pregnant with you.

PS


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Colorectal cancer screening

Medicare covers colorectal cancer screening tests to help find pre-cancerous polyps

(growths in the colon) so they can be removed beore they become cancerousand to help find colorectal cancer at an early stage when treatment works best.reatment works best when colorectal cancer is ound early.

Whos covered?

All people with Medicare 50 and older, but theres no minimum age or havinga screening colonoscopy.


Screening fecal occult blood testOnce every 12 months.

Screening flexible sigmoidoscopyOnce every 48 months afer the lastflexible sigmoidoscopy or barium enema, or 120 months afer a previousscreening colonoscopy.

Screening colonoscopyOnce every 120 months (high risk every 24months) or 48 months afer a previous flexible sigmoidoscopy.

Screening barium enemaOnce every 48 months (high risk every 24months) when used instead o sigmoidoscopy or colonoscopy.


You pay nothing or the ecal occult blood test. You pay nothing or the flexiblesigmoidoscopy or screening colonoscopy i your doctor accepts assignment.

Note:I a polyp or other tissue is ound and removed during thecolonoscopy, you may have to pay 20% o the Medicare-approved amountor the doctors services and a copayment in a hospital outpatient setting.

For barium enemas, you pay 20% o the Medicare-approved amount or thedoctors services. Te Part B deductible doesnt apply. I its done in a hospitaloutpatient setting, you pay a copayment.

Am I at high risk for colorectal cancer?Risk or colorectal cancer increases with age. Its important to continue withscreenings, even i you were screened beore you had Medicare. Your risk orcolorectal cancer increases i any o these are true:

Youve had colorectal cancer beore.

You have a close relative who had colorectal polyps or colorectal cancer.

You have a history o polyps.

You have inflammatory bowel disease (like ulcerative colitis or Crohns disease).

PS


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PS

PS

Depression screening

Whos covered?



Medicare covers one depression screening per year. Te screening must bedone in a primary care setting (like a doctors office) that can provide ollow-up treatment and reerrals.


You pay nothing or this test i your doctor or other qualified health care

provider accepts assignment.

Diabetes screening and self-management training

Diabetes is a medical condition in which your body doesnt make enoughinsulin, or has a reduced response to insulin. Diabetes causes your blood sugarto be too high because insulin is needed to use sugar properly. A high bloodsugar level isnt good or your health. Medicare covers a blood screening test tocheck or diabetes or people at risk. For people with diabetes, Medicare coverseducational training to help manage their diabetes.

Diabetes screening (Fasting blood glucose test)

Whos covered?

People who are at risk or diabetes.


Based on the results o your screening tests, you may be eligible or up to 2diabetes screenings per year.


You pay nothing or this screening.


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Diabetes screening and self-management training (continued)

Are you at high risk for diabetes?

Youre considered at high risk i you have high blood pressure, dyslipidemia(history o abnormal cholesterol and triglyceride levels), obesity, or a history ohigh blood sugar (glucose). Medicare also covers these tests i you answer yesto 2 or more o the ollowing questions:

Are you 65 or older?

Are you overweight?

Do you have a amily history o diabetes (parents, brothers, or sisters)?

Do you have a history o gestational diabetes (diabetes during pregnancy), or

have you had a baby weighing more than 9 pounds?

Diabetes self-management training

Whos covered?

Tis training is or people with diabetes to teach them to manage theircondition and prevent complications. You must have a written order rom adoctor or other health care provider.

Your costs if you have Original Medicare.

You pay 20% o the Medicare-approved amount afer the yearly Part Bdeductible.


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Glaucoma tests

Glaucoma is an eye disease caused by high pressure in the eye. It can develop

gradually without warning and ofen without symptoms. Te best way orpeople at high risk or glaucoma to protect themselves is to have regular eyeexams.

Whos covered?

People with Medicare whose doctor says theyre at high risk or glaucoma.



Your costs if you have Original MedicareYou pay 20% o the Medicare-approved amount afer the yearly Part Bdeductible.

Am I at high risk for glaucoma?

Your risk or glaucoma increases i any o these are true:

You have diabetes.

You have a amily history o glaucoma.

Youre Arican-American and 50 or older.

Youre Hispanic and 65 or older.

HIV screening

Medicare covers voluntary HIV (Human Immunodeficiency Virus) screeningsor people at increased risk or the inection, including anyone who asks orthe test and pregnant women.


Medicare covers this test once every 12 months, or up to 3 times during apregnancy.


You pay nothing or this test.

PS

PS


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Medical nutrition therapy

Medicare may cover medical nutrition therapy i you have diabetes or kidney

disease, and your doctor reers you or this service. Tese services can begiven by a registered dietitian or Medicare-approved nutrition proessional,and include a nutritional assessment and counseling to help you manage yourdiabetes or kidney disease.

Whos covered?

Certain people who have any o these:

Diabetes

Renal disease (people who have kidney disease, but arent on dialysis)

Have had a kidney transplant within the last 3 years

Your doctor needs to reer you or this service.


Medicare covers 3 hours o one-on-one counseling services the first year,and 2 hours each year afer that. I your condition, treatment, or diagnosischanges, you may be able to get more hours o treatment with a doctorsreerral. A doctor must prescribe these services and renew your reerral yearlyi continuing treatment is needed into another calendar year.


You pay nothing or these services i the doctor accepts assignment.

For more information about diabetes and medical nutrition therapy

Visit www.medicare.gov/publications toview the booklet Medicare Coverageo Diabetes Supplies & Services. You can also call 1-800-MEDICARE(1-800-633-4227). Y users should call 1-877-486-2048.

PS
http://www.medicare.gov/publicationshttp://www.medicare.gov/publications


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Obesity screening and counseling

Medicare covers intensive behavioral therapy or people with obesity, definedas a body mass index o 30 or more.

Whos covered?

All people with Medicare may be screened or obesity. Counseling is coveredor anyone ound to have a body mass index o 30 or more.


Tis counseling may be covered i you get it in a primary care setting (like adoctors office). alk to your primary care doctor or primary care practitionerto find out more.

People with a body mass index o 30 or more are eligible or:

One ace-to-ace visit each week or the first month

One ace-to-ace visit every other week or months 26

One ace-to-ace visit every month or months 712, i you lose 6.6 poundsduring months 16


You pay nothing or this service i your primary care doctor or other qualified

primary care practitioner accepts assignment.

PS


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Prostate cancer screening

Prostate cancer may be ound by testing the amount o PSA (Prostate Specific

Antigen) in your blood. Another way prostate cancer may be ound is whenyour doctor perorms a digital rectal exam. Medicare covers both o these tests.

Whos covered?

All men with Medicare over 50 (coverage or this test begins the day afer your50th birthday).


Digital rectal examinationOnce every 12 months.

PSA testOnce every 12 months.Your costs if you have Original Medicare

Generally, you pay 20% o the Medicare-approved amount or the digital rectalexam afer the yearly Part B deductible. Teres no coinsurance and no Part Bdeductible or the PSA test.

Am I at high risk for prostate cancer?

alk to your doctor or practitioner about whether youre at risk or prostatecancer.

PS


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Sexually transmitted infections screening and counseling

Medicare covers sexually transmitted inection (SI) screenings or chlamydia,

gonorrhea, syphilis, and/or Hepatitis B.

Whos covered?

People with Medicare who are pregnant and/or certain people who are atincreased risk or an SI when the tests are ordered by a primary care doctoror other primary care practitioner.


Medicare covers these tests once every 12 months or at certain times duringpregnancy. Medicare also covers up to 2 individual 20 to 30 minute, ace-to-ace, high-intensity behavioral counseling sessions each year or sexually activeadults at increased risk or SIs. Medicare will only cover these counselingsessions i theyre provided by a primary care doctor or other primary carepractitioner and take place in a primary care setting (like a doctors office).Counseling conducted in an inpatient setting, like a skilled nursing acility,wont be covered as a preventive service.

Your costs if you have Original Medicare.

You pay nothing or these services i your primary care doctor or otherqualified primary care practitioner accepts assignment.

PS


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Shots (flu, pneumococcal, Hepatitis B)

Medicare covers flu, pneumococcal, and Hepatitis B shots. Flu, pneumococcal

inections, and Hepatitis B can be lie threatening to an older person. All people65 and older should get flu and pneumococcal shots. People with Medicarewho are under 65 but have chronic illness, including heart disease, lung disease,diabetes, or End-Stage Renal Disease (ESRD) (permanent kidney ailurerequiring dialysis or a kidney transplant) should get a flu shot. People at mediumto high risk or Hepatitis B should get Hepatitis B shots.

Flu shot

Whos covered?



Once a flu season.


You pay nothing i your doctor or health care provider accepts assignment orgiving the shot.

Pneumococcal shot

Whos covered?All people with Medicare.


Most people only need this shot once in their lietime.


You pay nothing i your doctor or health care provider accepts assignment orgiving the shot.

PS


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Shots (flu, pneumococcal, Hepatitis B) (continued)

Hepatitis B shots

Whos covered?

Certain people with Medicare whose doctor says theyre at medium or high riskor Hepatitis B.


Tree shots are needed or complete protection. Check with your doctor aboutwhen to get these shots i you qualiy to get them.


You pay nothing i your doctor or health care provider accepts assignment.

Am I at medium or high risk for Hepatitis B?

Tese are some o the actors that put you at medium or high risk or Hepatitis B:

Hemophilia

ESRD (End-Stage Renal Disease)

Diabetes

Certain other conditions that increase your risk or inection, like i you livewith someone who has Hepatitis B, or i youre a health care worker and haverequent contact with blood or body fluids.

Other actors may increase your risk or Hepatitis B. Check with your doctor tosee i youre at medium or high risk or Hepatitis B.

PS


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Tobacco use cessation counseling

Te U.S. Surgeon General has reported that quitting smoking and stopping

tobacco use leads to significant risk reduction or certain diseases andother health benefits, even in older adults who have smoked or years. Anyperson who uses tobacco can get counseling rom a qualified doctor or otherMedicare-recognized practitioner who can help them stop using tobacco.

Whos covered?

Medicare covers these counseling sessions as a preventive service i you haventbeen diagnosed with an illness caused by tobacco use.


Medicare will cover up to 8 ace-to-ace visits during a 12-month period. Tesevisits must be provided by a qualified doctor or other Medicare-recognizedpractitioner.


You pay nothing or the counseling sessions.

Ask your doctor about Medicare-covered tobacco cessation programs nearyou, or visit www.nih.gov or more inormation about stopping tobacco use.

PS
http://www.nih.gov/http://www.nih.gov/


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Welcome to Medicare preventive visit

Medicare covers a one-time preventive visit within the first 12 months that you have

Medicare Part B. Tis visit is called the Welcome to Medicare preventive visit. Tevisit is a great way to get up-to-date on important screenings and shots and to talkwith your doctor about your amily history and how to stay healthy.

What happens during the visit?

During the visit, your doctor will:

Record your medical and social history (like alcohol or tobacco use, your diet,and your activity level).

Check your height, weight, and blood pressure.

Calculate your body mass index. Give you a simple vision test.

Review your potential risk or depression and your level o saety.

Offer to talk with you about creating advance directives. Advance directives arelegal documents that allow you to put in writing what kind o health care youwould want i you were too ill to speak or yoursel.

Depending on your general health and medical history, youll get advice,education, and counseling to help you prevent disease, improve your health, andstay well. Youll also get a written plan (like a checklist) letting you know which

screenings, shots, and other preventive services you need.

People at risk or abdominal aortic aneurysmsmay get a reerral or a one-timescreening ultrasound at their Welcome to Medicare preventive visit.I you have a amily history o abdominal aortic aneurysms, or youre a man 65 to75 and you have smoked at least 100 cigarettes in your lietime, youre consideredat risk. You pay nothing or this screening ultrasound.

What should I bring to the visit?

When you go to your Welcome to Medicare preventive visit, bring these items: Your medical records, including immunization records (i youre seeing a new

doctor). Call your old doctor to get copies o your medical records.

Your amily health historytry to learn as much as you can about your amilyshealth history beore your appointment. Any inormation you can give yourdoctor can help determine i youre at risk or certain diseases.

A list o prescription and over-the-counter drugs that you currently take, howofen you take them, and why.

PS


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One-time Welcome to Medicare preventive visit (continued)

Whos covered, and how often is it covered?

Tis visit is only covered one time, and you must have the visit within the first12 months youre enrolled in Part B.


You pay nothing i your doctor accepts assignment.

Yearly Wellness visit

I youve had Part B or longer than 12 months, you can get a yearly Wellnessvisit to develop or update a personalized prevention plan based on your current

health and risk actors. Tis includes:

Health risk assessment (Your doctor or health proessional will ask you toanswer some questions beore or during your visit, which is called a healthrisk assessment. Your responses to the questions will help you and your healthproessional get the most rom your yearly Wellness visit.)

Review o medical and amily history.

Develop or update a list o current providers and prescriptions.

Height, weight, blood pressure, and other routine measurements.

Detection o any cognitive impairment. Personalized health advice.

A list o risk actors and treatment options or you.

A screening schedule (like a checklist) or appropriate preventive services.




You pay nothing or this visit i your doctor accepts assignment.

You dont need to have had a Welcome to Medicare preventive visit beoregetting a yearly Wellness visit. I you do get the Welcome to Medicarepreventive visit during your first year with Part B, youll have to wait 12 monthsbeore you can get your first yearly Wellness visit.

PS


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Preventive services checklist

Keep track o the preventive services you need by using the chart below. You can also visitwww.MyMedicare.gov totrack your preventive services, get a 2-year calendar o the

Medicare-covered tests and screenings youre eligible or, and print a personalized on the goreport to take to your next doctors appointment.

page pageMedicare-covered

preventive service

I need

(yes/

no)

25 Abdominal aorticaneurysm screening

9 Alcohol misuse screeningand counseling

10 Bone mass measurement

11 Breast cancer screening(mammogram)

12 Cardiovascular disease(behavioral therapy)

12 Cardiovascular diseasescreenings

13 Cervical and vaginal cancerscreening

14 Colorectal cancerscreenings

14 Fecal occult blood test

14 Flexible sigmoidoscopy

14 Colonoscopy

14 Barium enema

15 Depression screening

15 Diabetes screenings

Medicare-covered

preventive service

I need

(yes/

no)

15 Diabetes sel-managementtraining

22 Flu shots

17 Glaucoma tests

23 Hepatitis B shots

17 HIV screening

18 Medical nutrition therapyservices

19 Obesity screening andcounseling

22 Pneumococcal shot

20 Prostate cancer screenings

24 Sexually transmittedinections screening andcounseling

24 obacco use cessationcounseling (counselingor people with no sign otobacco related disease)-

25 Welcome to Medicarepreventive visit (one-time)

26 Yearly Wellness visit
http://www.mymedicare.gov/http://www.mymedicare.gov/


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Notes

For more information about Medicare preventive services

You can learn more about Medicares preventive services by visiting www.medicare.gov. Youcan also call 1-800-MEDICARE (1-800-633-4227). Y users should call 1-877-486-2048.
http://www.medicare.gov/http://www.medicare.gov/


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29

SECION

3 Abdominal aortic aneurysm 25Alcohol misuse screening and counseling 9Barium enema 14Bone mass measurement 10Breast cancer screening 11Cardiovascular disease (behavorial therapy) 12Cardiovascular disease screening 12Cervical cancer screening 13Colorectal cancer screening 14Crohns disease 14Diabetes screening 15Diabetes sel-management training 15Diabetes supplies 15Digital rectal examination 14Drug coverage 7Eye disease 17Eye exams 17Fasting blood glucose test 15Fecal occult blood test 14Flexible sigmoidoscopy 14

Flu shot 22

Index

RememberThe

services listed in

this booklet are

covered if you

have Medicare

Part B (Medical

Insurance).


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30 Section 3: For More Information

Index (continued)

Glaucoma 17Glucose monitors 15Hepatitis B shot 22Immunizations (shots) 22Insulin 15Lancets 15Mammogram 11Medical nutrition therapy 18Obesity screening and counseling 19Osteoporosis 10

Pap test 13Pelvic exam 13Pneumococcal shot 22Preventive services checklist 27Prostate cancer screening 20Prostate Speciic Antigen (PSA) test 20Screening colonoscopy 14Sexually transmitted inections screening and counseling 21obacco use cessation counseling 24est strips 15obacco use 24Ulcerative colitis 14Vaginal cancer screening 13Welcome to Medicare

preventive visit 9Yearly Wellness visit 26


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Oicial BusinessPenalty or Private Use, $300

CMS Product No. 10110Revised February 2013

U.S. DEPARTMENT OF HEALTH AND

HUMAN SERVICES

Centers for Medicare & Medicaid Services

7500 Security Boulevard

Baltimore, Maryland 21244-1850

Medicare's Preventive Services

Documents

Transcript of Medicare's Preventive Services