15 Things You Didn’t Know Medicare Covers
When it comes to understanding your Medicare coverage, there are a lot of things to keep track of. Between premiums, understanding the different parts of Medicare and managing your plan type, it’s natural some smaller services might not get as much attention. Today, we’re looking at 15 lesser-known things Medicare covers.
For this blog, we’re looking at things that would be covered by Original Medicare, particularly Original Medicare Part B. Products like Medicare Advantage plans will also cover these things but may have additional services depending on the plan. All Medicare products cover the same things Original Medicare covers, so you will have access to these services no matter what type of coverage plan you’re enrolled in.
1. Welcome to Medicare preventive visit
When you first enroll in Medicare, you get access to an often-overlooked service right off the bat: your Welcome to Medicare visit!
This is an appointment with your Medicare-covered primary care physician to have an overall checkup to establish a baseline for your health and determine a health management plan for the upcoming year, including reviewing current health conditions and evaluating your medication needs.
2. Yearly wellness visits
Just like with your Welcome to Medicare visit, Medicare also covers an annual meeting with your primary care physician to get a yearly checkup and review your care plan.
This doesn’t mean that this is the only time you can visit your doctor; instead this is to make sure you have one appointment per year focused on reviewing your overall health and making sure everything you currently do for your health meets your needs.
3. Counseling to stop smoking or using tobacco products
Want to quit smoking? Medicare can help.
Medicare covers up to eight face-to-face visits per year to work on your tobacco use and help you quit once and for all. These visits can be with your doctor or another qualified health care provider who will help you plan for quitting and help you through the physical and emotional aspects of tobacco dependence.
Since this is a preventive service, many have zero out-of-pocket costs for these services.
- Did you know? If you smoke or have quit smoking in the last 15 years, Medicare may also cover yearly lung cancer screenings as well. For those with a history of tobacco use, annual lung screenings can help detect cancer and help inform future treatment.
4. Flu shots
Did you know that Medicare covers the cost of your flu shot? Influenza — more commonly called “the flu” — can be a serious health risk for seniors, and one of the best defenses you have against it is the flu shot.
Medicare will cover the flu shot whether you get it at a doctor’s office or at your local pharmacy. When paired with health safety practices like frequent hand washing, your flu shot can help you stay healthy throughout the flu season.
5. Nutrition therapy services
For those with qualifying conditions, such as diabetes or kidney disease, Medicare may cover the costs of nutrition therapy services.
This provides a nutrition and lifestyle assessment to establish your concerns and working with a registered dietitian to establish and monitor a nutrition plan that meets your specific needs. This service is also available to those who have experienced a kidney transplant in the past three years.
6. Alcohol misuse screening & counseling
Alcohol misuse, especially in seniors, can have serious health consequences. Medicare covers an alcohol misuse screening once per year for adults who use alcohol but don’t meet the medical criteria for alcohol dependency.
If your doctor determines you’re misusing alcohol, you can get up to four brief face-to-face counseling sessions each year (providing you are competent and alert during your visits) to help you address your alcohol usage.
7. COVID-19 vaccination and boosters
COVID-19 is known to be particularly dangerous for seniors. One of the best defenses out there is the COVID-19 vaccine and boosters to help support immunity against emerging strains.
At first, vaccines were only available at certain locations, but now you can get it at your doctor’s office or your local pharmacy. Continued health vigilance about COVID-19 not only helps keep you safe but can help stop the spread of future variants and outbreaks.
8. COVID-19 tests (including antibody tests)
Medicare covers all types of COVID-19 tests.
If you are feeling sick, there are a variety of tests available to determine if you have COVID-19. At-home rapid tests can give you answers within 15 minutes, while PCR tests take a little longer but offer increased sensitivity. Even if you’re not feeling sick, Medicare will cover antibody tests to determine your potential ability to overcome future exposure.
9. COVID-19 monoclonal antibody treatments
If you test positive for COVID-19 and have mild to moderate symptoms, monoclonal antibody treatments can help fight the disease and keep you out of the hospital.
This treatment is an infusion of monoclonal antibodies provided in certain medical settings. These treatments are particularly used for those with high complication risks for COVID-19 that increase your chances of needing hospitalization.
10. Obesity screening & counseling
If you have a body mass index (BMI) of 30 or more, Medicare Part B (medical insurance) covers obesity screenings and behavioral counseling to help you lose weight by focusing on diet and exercise.
You can do this counseling with your primary care doctor or another qualified practitioner, such as a registered dietitian, to help you meet your goals and live a healthier life.
11. Gender-specific cancer screenings
Medicare covers specific cancer screenings for both men and women.
Prostate cancer screenings using prostate specific antigen (PSA) blood tests are covered once every 12 months for men.
Likewise, screening mammograms and Pap smears are covered for women once each year when performed by a qualified health care provider.
- Friendly reminder: Digital rectal exams and diagnostic mammograms are not treated the same as screenings by your Medicare coverage, so be sure to review your plan’s rules for more information about diagnostic and exam costs.
12. Diabetes self-management training
If you have been recently diagnosed with diabetes, your doctor can provide a written order for you to receive diabetes self-management training (DSMT). DSMT teaches you to cope with and manage your diabetes.
The program may include tips for eating healthy and being active, monitoring blood sugar, how to administer insulin injections and reducing risks of blood sugar imbalance. Medicare may cover up to 80% of your DSMT appointments up to 10 hours, and two hours of follow-up training if future assistance is needed.
13. Special footwear for those with diabetes
For those with diabetes, neuropathy in the feet can become a serious health issue. One of the ways to keep your feet safe is by using footwear designed specifically for those with diabetes.
Therapeutic shoes and inserts will need to be prescribed by a Medicare-approved podiatrist and have a limit of one pair of shoes and a couple additional inserts per year. This applies to both custom-molded shoes and extra-depth shoes.
For those who qualify and have met their deductible, Medicare may cover up to 80% of your footwear costs.
14. Colorectal cancer screenings
There are several diagnostic screenings and tests doctors can use to look for signs of colorectal cancer. Multitarget stool DNA tests are an at-home option for those who are at an average risk of cancer and will be covered once every three years as needed.
Colonoscopies aren’t exactly fun, but they are an important tool to determine if you have colorectal cancer or other health concerns like ulcers. Colonoscopies are completely covered by Medicare, meaning you will pay nothing for the procedure, once every 24 months if you’re at high risk for colorectal cancer. If you aren’t at high risk, Medicare still covers the test but not as often.
15. Depression screenings
Seniors are one of the most vulnerable age groups for depression because the retirement years can be a major lifestyle adjustment. Medicare offers a yearly depression screening at no cost.
This meeting will be with your primary care doctor to address emotional concerns and look for signs of depression. If your doctor believes you have depression, referrals to mental health professionals or prescription options might be presented to you, although your coverage on these services may vary.
- If you or someone you know is experiencing depression or a mental health crisis, call or text 988 or click here to chat with the Suicide and Crisis Lifeline. Please call 911 if the situation is an emergency.
Bonus: The Medicare “What’s Covered” smartphone app
We know we said 15 things, but this one was too important to leave off.
Medicare, in addition to their other great services, provides an app for your smartphone to let you look up covered services. Find out coverage amount and copay information directly from your phone. Learn more about the app here.
Medicare offers coverage for many important medical screenings, tests and services. Understanding that coverage can help you better manage your own care and understand your coverage needs. Another way to understand coverage and ensure you have the best coverage option for your situation is to talk to a Medicare agent.
With a little information from you, the licensed agents at Medicare Allied can run quotes for many kinds of coverage, from Medicare plans to prescription drug plans to life insurance solutions and more.
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