Overlooked Preventive Medicare Benefits That Women Can’t Afford to Miss

As a Medicare Customer Advocate for a large US insurance company, one of the things I have learned is that many women are unaware of the free or low-cost preventive screenings and tests that their Medicare plans cover.

I’ve heard it all: “I didn’t know mammograms were free”, “My friends are getting osteoporosis screenings; does Medicare cover that?”, “I haven’t had a colonoscopy in like 20 years, am I eligible for that on my plan?”

You get it; the list of questions is inexhaustible.

What Exactly IS Preventive Care?

Medicare’s Preventive Care benefits focus on pinpointing health concerns early, or preventing them entirely, before they become more serious and more expensive to treat.

The Good News

Medicare covers a gamut of preventive tests and screenings for free or at a low cost to help women stay their healthiest during this chapter in their lives, so check out these benefits!

Medicare Annual Wellness Visits

Unlike traditional physical exams, this yearly checkup allows you and your healthcare provider to review your overall health, assess risk factors, update preventive screenings, and create a personalized wellness plan. Think of it as an annual roadmap for maintaining your health.

New to Medicare? Did you know that before your Annual Wellness Visit benefit kicks in, you are eligible for the one-time “Welcome to Medicare” preventive appointment with your doctor? This visit, which is only good for within the first year you have joined Medicare, gives you and your doctor the chance to review your medical history and your family’s medical history. Your doctor will also inform you about important, covered vaccines and screenings, and best ways for you to stay healthy.

Mammograms

Mammograms can help detect breast cancer in its earliest and most treatable stages. Screening mammograms are covered every 12 months, or more frequently, based on medical necessity.

Bone Density Tests

Bone density tests, which are covered every 24 months or more often, based on medical necessity, can identify osteoporosis before a fracture occurs, a particularly important concern for post-menopausal women. Your doctor will also discuss with you best ways to keep your bones strong.

Cervical and Vaginal Cancer Screenings

These screenings also cover Human Papillomavirus (HPV) tests. These tests are usually covered once every 24 months, but if you are at a high risk for these cancers or have had an abnormal Pap result in the last 36 months, this test will be covered every 12 months.

Colonoscopies

A colonoscopy checks for precancerous polyps in your colon, colon cancer, and other diseases in the colon and rectum. Medicare will cover this screening every 24 months if you are at high risk for colon cancer; if you’re not at high risk, they are covered every 10 years.

Diabetes Screenings

A diabetes screening checks to see if you have diabetes, or you may be at risk for diabetes, and may include a fasting or non-fasting test, an A1C screening, or other Medicare-approved glucose tests.

Bear in mind that this Medicare-preventive coverage is based on whether your health care provider believes you may be at risk for developing diabetes. Medicare will cover up to two of these tests annually, based on the date you went for your most recent screening, not per calendar year.

Depression Screenings

Let’s face it; life can be rough sometimes and can get you down in the dumps. If you have been feeling this way for a while, see your doctor, as this benefit is covered yearly. Your provider will ask you questions to find out if you have depression, and if so, will determine the appropriate follow-up treatment, whether that is medication, a referral to a mental health provider, or both.

Cardiovascular Disease Screenings

Your doctor will check for any heart or blood vessel problems and will determine if you’re at risk for heart disease. This preventive screening also covers tests for cholesterol, lipid and triglyceride levels, and is covered once every five years.

Vaccines and Shots

Yes, Medicare even covers the following jabs to keep you healthy:

• COVID-19 vaccines and other related services.
• Flu Vaccines are covered each year during the flu season.
• Hepatitis B vaccines help prevent against this virus.
• Pneumococcal shots protect you against pneumonia.

Mind you, this list is not exhaustive; Medicare provides beneficiaries with even more preventive services, so check them out!

What to Do Before You Go

Before you go for your preventive screening or test, please note that you pay nothing (or pay a low cost) for these benefits, as long as you receive them from a doctor or health care provider who accepts Medicare.

It is also best practice to call your doctor or your insurance company to confirm or determine that the preventive service you have scheduled is at no cost.

Keep in mind that when you attend your screening, your provider may suggest additional services which Medicare may not cover. You may find that you may have additional financial responsibilities for any other tests or procedures above and beyond the initial covered test.

If you have a Medicare plan through an insurance company, call your company to determine whether you have any co-pay, co-insurance or deductible amounts you could be billed.

An Ounce of Prevention

These covered Medicare preventive screenings and tests play a powerful role in helping you stay healthy, independent and active well into this time of your life. You’ve worked hard for many years to obtain your Medicare health benefits. Empower yourself to know these extra perks from Medicare and do take advantage of them.

Schedule your Medicare test or screening as soon as you can – it may just help save your life!

Join the Conversation:

What preventive Medicare benefits have you used? Was there a time when a medical issue you experienced was caught early through a preventive test or screening, and how did that make a difference in your life? What advice or encouragement would you suggest to other women who may be “appointment-shy” when scheduling these benefits?