Which Preventive Services Are Covered By Medicare?

There are a number of preventative screenings and services covered by Medicare, many of them free. Some screenings are only for women or men, some are covered twice a year and some only available once.

What Services Are Offered To Only Men Or Women?

There is only one preventative service specifically intended for men. Prostate cancer screening is available for men, with both Digital Rectal Exam and the Prostate Specific Antigen (PSA) test covered once every 12 months. Only the PSA test is fully covered, the Digital Rectal Exam has a post-deductible 20% copay. For women there are 2 major screenings–mammograms and pelvic exams to screen for breast, cervical and vaginal cancers. Both are fully covered as of January 1, 2011.

What Services Does Medicare Cover On A Limited Basis?

Several preventative screenings are only covered a limited number of times, or for recipients with specific risk factors. Medicare recipients who have family history or other risk factors can receive one Abdominal Aortic Aneurism screening ultrasound, if referred from the “Welcome to Medicare” exam and it is done during the first 12 months of coverage. Glaucoma and diabetes testing are covered with a 20% copay under Medicare Part B for people with risk factors. Medical Nutrition Therapy is fully covered if referred, as is Bone Mass Measurement.

What Services Are For Everyone?

Everyone with Medicare is eligible for a “Welcome to Medicare” physical in their first 12 months of coverage, and a Wellness check-up every twelve months after that for free. Cardiovascular screening blood tests are covered entirely by Medicare once every five years. Colorectal cancer screening is covered once every 12 to 120 months, depending on the type of test. Flu, pneumococcal and Hepatitis B vaccination are available as needed. Counseling to quit smoking is covered up to eight visits in 12 months. Finally, HIV testing is available as requested once every 12 months for adults, or a maximum of three times per pregnancy.

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