What Older Adults Should Know About Medicare Preventive Services
Schedule your Welcome to Medicare and yearly Medicare wellness visit today
There are steps that all of us can take to promote healthy aging, including eating nutritious foods, getting regular exercise and keeping up with our medical visits. Prevention is the key to finding medical problems early. You should be sure to take advantage of the important preventive services that Medicare covers.
Preventive services weren't always covered by Medicare, which used to mainly focus on diagnosis and treatment, with few services aimed at prevention. That changed in 2010, when the Affordable Care Act added preventive services for all Medicare beneficiaries.
It can be confusing, however, to know exactly which services and screenings Medicare covers, when they're covered and what to expect. That's why the Alliance for Aging Research, a nonprofit organization dedicated to accelerating the pace of scientific discoveries and their application to vastly improve the universal human experience of aging and health, created the fact sheet, "Wellness Wisdom: A Guide to Preventive and Screening Services Covered by Medicare" to help older adults and their families learn more about prevention through Medicare.
"It's important for older adults to know about yearly wellness visits and other preventive services covered by Medicare," says Lindsay Clarke, vice president of health education and advocacy at the Alliance. "Knowing about when to schedule visits, how to prepare for them, what is and isn't covered and whether there will be any out-of-pocket costs will help you get the preventive care you personally need to stay healthy for as long as possible."
Medicare covers the "Welcome to Medicare" preventive visit and the yearly "Wellness" visits. While these visits aren't head-to-toe physicals, they are a great opportunity for beneficiaries to make sure they are up to date on important screenings and vaccines. It's also an ideal time to share family and medical history and create a personalized prevention plan with your provider.
Everyone, whether or not they have a chronic condition, should schedule these visits. These visits are free with original Medicare and Medicare Advantage plans offered by private insurers. During these visits, your health care provider may recommend you get services that Medicare doesn't cover. If this happens, you may have to pay some or all of the costs. Ask questions so you understand why your provider is recommending certain services and whether Medicare will pay for them.
The "Welcome to Medicare" Preventive Visit
"You'll need to schedule this one-time visit as soon as your Medicare coverage starts, as the "Welcome to Medicare" preventive visit only covers individuals who've been on Medicare Part B for twelve months or less," Clarke said.
At this visit, your health care provider will ask questions about your medical, social and family history. Based on your health conditions and risk factors, your health care provider will discuss a preventive screening schedule for you. You'll also undergo routine measurements like weight and blood pressure, and a basic visual acuity screening.
Your health care provider should also take this time to discuss your depression risk and review any current opioid prescriptions — discussing your risk of opioid use disorders and any underlying pain you may be experiencing. You are eligible for a once-in-a-lifetime electrocardiogram so be sure to ask your provider if it's recommended for you.
"At this visit, you'll also want to let your health care provider know if you or have experienced any changes when it comes to memory or cognition, as they are not required to screen for cognitive or memory problems at this visit," Clarke says.
The Yearly "Wellness" Visit
After you've had Medicare Part B for 12 months, you are now eligible for a yearly visit in which your health care provider will review your health status and history and develop or update your personalized prevention plan. This visit will include a questionnaire that asks you about your risks, providers and medications; a conversation about your medical and social history; a review of your opioid use; routine measurements; screenings for depression or mood disorders; screenings for cognitive impairment and dementia; referrals for additional services and information on end-of-life planning, if desired.
"While a basic visual acuity screening is covered at the Welcome visit, Original Medicare doesn't cover routine eye exams for lenses or eyeglasses. It does cover some of the costs for eye injuries, surgeries and treatments and yearly eye exams for people at high risk; but not all care is covered, so check with your insurance in advance to find out what you'll be paying," Clarke says.
Preparing for Your Visits
For both of these visits, be sure to prepare by bringing along the following:
- A list of prescription drugs, over-the-counter drugs and supplements you take regularly
- A list of health care providers and suppliers
- Family health history—try to learn as much as you can about your family’s health history before your appointment
- Any other information that can help determine if you are at risk for certain diseases
For more information on preventive services covered by Medicare, please check out the Alliance's new fact sheet, "Wellness Wisdom: A Guide to Preventive and Screening Services Covered by Medicare."
For general information on Medicare and Medicare Open Enrollment — now to December 7, visit www.medicare.gov or call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.
The Alliance for Aging Research is the leading nonprofit organization dedicated to accelerating the pace of scientific discoveries and their application to vastly improve the universal human experience of aging and health. The Alliance believes advances in research help people live longer, happier, more productive lives and reduce health care costs over the long term.
