You can be proactive about your health with regular checkups and screenings. Get the most out of your Medicare plan by taking advantage of these covered services.

You’ve reached your golden years, and you’re feeling good about it. And now that you’re on the cusp of 65, you may need to start thinking about enrolling in Medicare. (Medicare is a health insurance program run by the government for people 65 or older, some younger people with disabilities and people with end-stage renal disease.)

But 65 is also the age when many health problems begin to emerge, says Robert Amler, M.D., M.B.A. He’s dean of the School of Health Sciences and Practice at New York Medical College and a practicing physician. That’s why taking care of your health is more important than ever as you age.

Fortunately, Medicare covers a range of preventive services that can help your doctor spot health problems before they become serious. These include the screenings, exams, labs and vaccinations that are most important for older adults.

Here’s a rundown of some key preventive services you can get through Medicare — and how you can receive them.

Thinking about enrolling in Medicare? Learn more about Medicare or call a licensed insurance agent at 1-844-211-7730 to discuss your options.

Medicare service #1: The “Welcome to Medicare” visit

When you join Medicare, you’ll have a chance to get a comprehensive checkup called a “Welcome to Medicare” visit (also known as the Initial Preventive Physical Exam). You’ll need to schedule this visit within the first year that you are enrolled in Medicare.

“This visit is a great opportunity for you and your health care provider to review your medical and social history as it relates to your health, including your medical diagnoses, family history and current medications and supplements,” says Maria C. Castillo-Catoni, M.D., with Northern Virginia Family Practice in Washington, D.C. “You will also be provided with education and counseling regarding preventive services.”

Here’s what you’ll get at this comprehensive visit:

• A calculation of your body mass index, or BMI
• A review of your potential risk of depression and your level of safety
• A simple vision test
• An offer to talk with you about creating an advance directive (a legal document that provides instructions for your health care in the event you’re not able to communicate your own wishes)
• Certain screenings and vaccinations and referrals for other care, if needed
• Height, weight and blood pressure measurements

You’ll also get a written plan letting you know which screenings, shots and other preventive services you need. If you’ve been getting regular checkups with the same doctor for years, this visit may be fairly uneventful. But if you haven’t been to the doctor in a while, it’s a chance to establish a relationship with your primary care provider and get a baseline overview of your health.

“It’s often been said in the field of medicine that we don’t see as many people in their 20s and 30s and 40s as we do people in their 60s and 70s and so forth,” Dr. Amler says. “The ‘Welcome to Medicare’ assessment is an opportunity to catch everybody up to where they should be.”

Your doctor will talk to you about more than just diseases and health conditions. “This visit should also include an evaluation of your ability to function independently (perform activities of daily living), your level of safety and your risk of falls,” says Dr. Castillo-Catoni.

The goal is to set you up for a healthy, independent life as you get older.

Have questions about Medicare? Learn about Medicare online or call a licensed insurance agent at 1-844-211-7730.

Medicare service #2: Annual wellness visits

Each year after your first year on Medicare, you are covered for an annual wellness visit (AWV). These checkups are a chance for you and your doctor to develop or update your personalized wellness plan.

The visit includes:

• A review of your current prescriptions
• A review of your medical and family history
• Advance care planning
• Personalized health advice
• Routine measurements (such as height, weight and blood pressure)

Your doctor will also assess your cognition and look for signs of dementia. That’s a general term that describes an impaired ability to remember, think or make decisions that can interfere with doing everyday activities. (Alzheimer’s is the most common form of dementia.)

So, getting an AWV every year allows your doctor to detect changes over time that you might not notice. “This visit is important because it presents an opportunity to create or update a personalized plan to prevent disease based on your current risk factors and health,” Dr. Castillo-Catoni says. “You do not need to have had a ‘Welcome to Medicare’ preventive visit to qualify for a yearly ‘wellness’ visit.”

It’s worth noting that an AWV is different than an annual physical, which is not covered at no cost by Medicare. Your doctor does not do a physical exam during an AWV. In fact, you may be able to get your AWV either over the phone or on a video call.

Medicare service #3: Medicare preventive services

During your wellness visits, your doctor will discuss any preventive screenings or tests you may need. Preventive screenings are done to detect problems, such as cancer or diabetes, before you might have any obvious symptoms. That way, your doctor can start treating them before they become more serious problems.

Medicare covers a number of preventive screenings. Some are covered for everyone. Others may only be covered for people with certain risk factors. For example, lung cancer screenings are only covered for current or former smokers.

Here are some common preventive screenings, tests and services that are covered by Medicare:

• Cardiovascular disease screening and prevention: This includes blood tests to measure your blood cholesterol levels. Medicare also covers counseling with your doctor about lifestyle choices that can help prevent heart disease.
• Colorectal cancer screenings: Medicare covers several different types of colorectal screening tests to detect and prevent colon and rectal cancers (sometimes called colorectal cancers). Which test you get, and how often you get it, will depend on your doctor’s recommendations.
• Diabetes screening and prevention: Depending on your risk level for diabetes, you may be eligible for up to 2 blood sugar tests each year to screen for the condition. Medicare also covers your enrollment in a diabetes prevention program if you are at high risk for diabetes. This program provides support with healthy eating, exercise and other lifestyle changes that can help prevent diabetes. If you’re diagnosed with diabetes, Medicare helps pay for diabetes self-management education.
• Lung cancer screenings: If you are a current smoker or have a history of smoking, you may be eligible for lung cancer screening at no cost.
• Mammograms (breast cancer screening): Medicare covers a screening mammogram once a year for all women. Diagnostic mammograms are also covered, but you’ll have to pay a portion of the cost.
• Mental health and substance abuse: Your doctor will screen you for depression and other mental health problems. They’ll also ask about alcohol use and provide counseling if needed. And, if you are a smoker or use tobacco, Medicare covers counseling to help you quit.
• Vaccinations: Medicare covers a flu shot every year as well as the COVID-19 vaccination (according to the latest recommendations from the Centers for Disease Control and Prevention). A pneumococcal vaccine (to prevent pneumonia) is covered once in your lifetime. If you have certain risk factors, a hepatitis B shot is also covered. Hepatitis B is a virus that causes the liver to become inflamed and can lead to long-term damage.

Medicare covers many other screenings that your doctor may recommend. Most of these preventive services are covered at no cost to you. But for some you may have to pay a share (20%) of the cost.

You’ll also have to pay a portion of the cost of diagnostic tests (such as diagnostic mammograms) and for care you need as a result of a screening test.

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Preparing for your appointments

Maintaining your health is a partnership between you and your doctor. You can also help your doctor out by preparing for your wellness visits and screenings. Whenever you have an appointment, be sure to come prepared with:

• Your Medicare and other insurance cards
• Your medical and immunization records
• Your family health history
• A list of any prescription drugs, over-the-counter drugs, vitamins and supplements you currently take (including details on why and how often you take them)

You’ll also want to write down any questions and concerns you have, so nothing slips your mind. Your doctor may keep track of what screenings you’ll need and when, but don’t be afraid to ask if there’s something in particular you’re worried about. Some people also find it helpful to bring along a friend or family member to take notes or ask follow-up questions.

Your Medicare plan covers many services that can help keep you happy and healthy. Be sure to take advantage of these services and more.

Need help finding a Medicare Advantage plan? Contact a licensed insurance agent at 1-844-211-7730.

Sources

Centers for Disease Control and Prevention. “About Dementia.” April 5, 2019. Retrieved from https://www.cdc.gov/aging/dementia/index.html

Medicare.gov. “Diabetes self-management training.” Retrieved from https://www.medicare.gov/coverage/diabetes-self-management-training Accessed April 16, 2023

Medicare.gov. “Mammograms.” Retrieved from https://www.medicare.gov/coverage/mammograms Accessed April 16, 2023

Medicare.gov. “Costs.” Retrieved from https://www.medicare.gov/basics/costs/medicare-costs Accessed April 16, 2023

Medicare.gov. “Preventing & screening services.” Retrieved from https://www.medicare.gov/coverage/preventive-screening-services Accessed April 16, 2023

Medicare.gov. “’Welcome to Medicare’ preventive visit.” Retrieved from https://www.medicare.gov/coverage/welcome-to-medicare-preventive-visit Accessed April 16, 2023

Medicare.gov. “Yearly ‘Wellness’ Visits.” Retrieved from https://www.medicare.gov/coverage/yearly-wellness-visits Accessed April 16, 2023

National Institute on Aging. “Advance Care Planning: Advance Directives for Health Care.” Retrieved from https://www.nia.nih.gov/health/advance-care-planning-advance-directives-health-care Accessed April 16, 2023

National Institute on Aging. “How to Prepare for a Doctor’s Appointment.” February 3, 2020. Retrieved from https://www.nia.nih.gov/health/how-prepare-doctors-appointment

Disclaimer

For informational purposes only. This information is compiled by [Name of entity] and does not diagnose problems or recommend specific treatment. Services and medical technologies referenced herein may not be covered under your plan. Please consult directly with your primary care physician if you need medical advice.

Compliance Code
49905-X-0723