I’m in the process of taking some Medicare certification courses, and I came across some important information that you (or a friend or family member) may not be aware of. Did you know that under your Medicare Part B benefits, you are entitled to certain preventive services and screenings, and there is no cost-sharing for most of these services?  Please take a few minutes and check these out. You may find some benefits that you didn’t realize you were entitled to!

Preventive Services Include the Following:

• One-time “Welcome to Medicare” physical exam
• Annual wellness visit after 12 mos. enrolled in Part B
• Immunizations – pneumococcal, hepatitis B, annual flu shot
• Abdominal aortic aneurysm screening – one time, with referral
• Alcohol misuse screening – every 12 months for certain individuals
• Bone mass measurement – every 24 months for certain conditions
• Cardiovascular screening blood tests – every five years for all persons
• Colorectal cancer screening – four different tests, vary in frequency
• Depression Screening – every 12 months
• Diabetes screenings – up to two per year for those with risk factors
• Diabetes self-management training – for persons with diabetes
• Glaucoma testing – once per year for those at high risk
• HIV Screening
• Intensive Behavioral Therapy for Cardiovascular Disease – one face-to-face visit annually in a primary care setting
• Mammogram (Breast Cancer Screening) – annual screening for most women
• Medical nutrition therapy – for those with diabetes/kidney disease or kidney transplant
• Obesity Screening and counseling – for certain individuals
• Pap test and pelvic examination – every 24 mos. for all women; every 12 mos. for those at high risk
• Prostate cancer screening – every 12 mos. for men over age 50
• Screening for Sexually Transmitted Infections (STIs) and High Intensity Behavioral
• Counseling to Prevent STIs – for certain individuals
• Smoking cessation counseling – for any illness related to tobacco use

Other Part B Items and Services:

• Ambulance services
• Ambulatory surgical center fees
• Blood
• Cardiac rehabilitation–for certain situations
• Chiropractic services–for limited situations
• Clinical research studies – some costs of certain care in approved studies
• Defibrillator (implantable automatic)
• Diabetic supplies
• Durable medical equipment – restricted to certain suppliers in some areas
• Emergency room services
• Eyeglasses after cataract surgery – limits apply
• Foot exams and treatment for certain diabetics
• Hearing and balance exams (no hearing aids)
• Home health services in certain situations
• Kidney dialysis and disease education – certain situations
• Mental health care (outpatient) – limits apply
• Occupational and physical therapy – limits apply
• Pulmonary rehabilitation for COPD
• Prosthetic/Orthotic items
• Second surgical opinions
• Speech-language pathology services
• Telehealth services in some rural areas
• Tests like X-rays, MRIs, CT scans
• Transplant physician services and drugs

The Following Items Are Not Covered by Medicare Part A & B:

• Acupuncture
• Dental care/dentures
• Cosmetic surgery
• Custodial care
• Health care while traveling outside the US – exceptions apply
• Hearing aids
• Orthopedic shoes
• Outpatient prescription drugs (covered under Part D)
• Routine foot care
• Routine eye care and eyeglasses
• Some screening tests and labs
• Vaccines, except as previously listed (those not covered under Part B are covered under Part D)
• Syringes and insulin unless used with an insulin pump (covered under Part D)

IMPORTANT WARNING REGARDING YOUR MEDICARE COVERAGE!

If you are on Medicare and you need to be admitted to a hospital, DO NOT let the hospital admit you with the words “UNDER OBSERVATION.” Insist on being admitted as “IN-PATIENT.” Otherwise, there is a good chance that you will be responsible for most or all of the hospital expenses, and you will be prevented from accessing nursing home care, rehabilitative care, etc. Click here to watch a recent NBC news television broadcast regarding this problem.

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