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Knowing What Preventative Services Medicare Will Cover

After enrolling in Medicare, it’s important to find out what preventative care services it will actually cover.

Whether you have an Advantage Plan or not, it’s Medicare Part B that covers preventative services. Unfortunately, not everything is included.

Of course, the last thing you want is to deal with a major medical problem that could have been averted. Therefore, knowing what your options are and how to take advantage of them is incredibly helpful in maintaining good health.

Understanding What Counts as Preventative Care

Certain healthcare services that help detect and prevent various conditions and diseases are considered preventative services. These services are intended to help you stay healthy and ensure you receive proper guidance from your doctor.

Some are covered by Medicare, though some are not. Often included in your coverage are things like wellness screenings, doctor visits, immunizations, x-rays, and even some lab work.

Considering how important it is to stave off issues before they arise, preventative care coverage is essential to staying healthy.

Health and Wellness Screenings

Once you’ve enrolled, you’ll be eligible for your first “Welcome to Medicare” preventative care visit within the first twelve months. During your visit, you’ll also be able to learn more about preventative care services.

After a year has passed, you’ll be able to take advantage of one “Annual Wellness Visit” per year. Again, this will help enable you to keep track of your various healthcare needs. Additionally, it’s a good opportunity to find out about other potentially needed screenings or services that might help you.

What’s Covered and What’s Not

On the Medicare website, you’ll find a tool that shows all covered preventative services.

For starters, they include screenings for abdominal aortic aneurysm, alcohol misuse, cardiovascular disease, cervical and vaginal cancer. Colorectal cancer and depression screenings are also usually covered. As are screenings for diabetes, hepatitis C, HIV, lung cancer, obesity, and prostate cancer.

You can also get tested for sexually transmitted diseases and infections. And, typically, mammograms and glaucoma tests are also covered.

Certain vaccinations are also covered by Medicare Part B. Immunization for the flu, pneumococcal shots, and hepatitis b shots are among those for which you’ll receive coverage.

Also, there are some mental health services that are covered as well. This might include counseling – however, there is a caveat in that the medical professional must accept the Medicare assignment. If accepted, preventative care services may cover visits to a psychiatrist, clinical social worker, clinical psychologist, or clinical nurse specialist.

Potential Charges You May Face

Original Medicare covers a surprisingly large number of preventative care services. However, as we’ve said before, it doesn’t cover everything. There’s a good chance you could still be liable for related services.

Yes, it can be a bit confusing. That’s why you’ll want to be extra careful in finding out what additional charges might arise. It’s important to speak with an administrative professional at your doctor’s office before proceeding with certain tests and treatments. No one likes dealing with unexpected bills including things like facility fees, diagnostics, or extraneous tests.

Coverage with a Medicare Advantage Plan

With a Medicare Advantage plan, your coverage will vary based on your insurer and the plan you selected.

Most Advantage plans will cover certain things not covered by Original Medicare. However, that’s often not without additional caveats. You’ll still need to research what’s covered by your specific plan and what your out of pocket costs may be.

Your Advantage Plan could potentially involve additional deductibles, co-pays, or other conditions. These things should be laid out for you in the insurer’s guidelines. Plus, you can always call and ask for help as well.

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