Medicare Preventative Services
What you need to know about Medicare Preventative Services
We encourage you to understand the details of Medicare Preventative Services. This is a beneficial and important program available to all Medicare beneficiaries who currently have Medicare Part B.
The Centers for Medicare and Medicaid Services (CMS) has prepared an easy to understand course that describes this program and how you can get started. This course is titled ‘Module 7 – Medicare Preventative Services’ and is available here. Note this course requires the Microsoft Powerpoint software for viewing.
Why do we like and encourage you to take the time to understand this program?
Preventive services may find health problems early when treatment works best. Medicare Part B covers preventive services like screening exams, wellness visits, lab tests, and immunizations to help prevent, find, and manage medical problems.
These services are covered whether you get your coverage from Original Medicare, a Medicare Advantage (MA) Plan, or another type of Medicare health plan. However, the rules for how much you pay for these services may vary. A Medicare health plan is a plan offered by a private company that contracts with Medicare to provide Part A and Part B (and sometimes Part D) benefits to people with Medicare who enroll in the plan. Medicare health plans include all MA Plans, Medicare Cost Plans, Demonstration/Pilot Programs, and Programs of All-inclusive Care for the Elderly.
Talk to your doctor about which preventive services you need, how often you need them to help you stay healthy, and if you meet the criteria for coverage based on your age, gender, and medical history.
Medicare Preventative Services … How much do they cost?
Many of these services are cost free. You can learn more by reading slide 4 and 5 on the above-mentioned course. The rules for how you get each service may vary and are covered in the course.
Medicare Preventative Services … What is actually covered?
At this writing, there are 25 services included in this program. There is a synopsis of each on slide 6. Each service has a separate slide that gets into the details.
Medicare Preventative Services … How do I get started?
You schedule your visit with your primary care physician. When you make the appointment be sure and use the words ‘I would like to schedule my Welcome to Medicare Preventative Visit’. Using this language gives the office staff the information they need to use the proper coding when they file their paperwork with Medicare.
You schedule your annual follow-up visits at 12-month intervals from your initial or prior visit. The sessions after your ‘Welcome to Medicare Preventative Visit’ are called ‘Yearly Wellness Visit’. We feel these visits are equally important for everyone to complete.
Remember, the purpose of these visits is to find health problems early, when treatment works best.
Medicare Preventative Services … what else do I need to know?
This visit does not take the place of an annual checkup/physical. You should be scheduling this as a separate visit. Be aware if during an annual Wellness visit you wish to discuss other health issues/have something checked that is not included in the ‘Wellness program’, you may be billed for this service separately.
Medicare can update the list of preventative services.
We encourage you to bookmark either this page or the page where the course is actually located AND check it annually for updates. We feel being informed about these services is important and all people enrolled in Part B should be taking advantage of this resource.
Call us if you are a resident of Idaho and want help understanding the differences between your Medicare Advantage, Medigap and insurance companies offering these products as well as prescription drug plans. We will help you enroll in the plan you choose and work with you annually to help you update your coverage as your needs change.
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