Annual Wellness Screening (Part 2)
By: Melody Rabor-Dizon
Annual wellness screening is an important health risk assessment that must be done yearly with your physician. This tool is intended to identify, assess, diagnose, intervene and evaluate your risk factors and create a plan of care based on your results. As the term implies, annual or yearly preventive measures must be addressed for early detection, prevention and treatment of chronic illnesses. Make sure you create a timeline for your personal check off list.
APPROVED SERVICES UNDER MEDICARE PART B: 14.
Lung cancer screenings: covers lung cancer screenings with Low Dose Computed Tomography (LDCT) once each year if you meet all of these conditions:
You’re age 55-77. You don’t have signs or symptoms of lung cancer (asymptomatic). You’re either a current smoker or have quit smoking within the last 15 years. You have a tobacco smoking history of at least 30 “pack years” (an average of one pack (20 cigarettes) per day for 30 years). You get a written order from your doctor.
15. Mammograms: covers:
One baseline mammogram if you’re a woman between ages 35-39.
Screening mammograms once every 12 months if you’re a woman age 40 or older.
Diagnostic mammograms more frequently than once a year, if medically necessary
16. Obesity behavioral therapy: covers screenings if you have a body mass index (BMI) of 30 or more. Medicare covers this counseling if your primary care doctor or other qualified provider gives the counseling in a primary care setting (like a doctor’s office), where they can coordinate your personalized prevention plan with your other care.
17. Pneumococcal shots: covers 2 different pneumococcal shots. Part B covers the first shot at any time and a different, second shot if it’s given at least one year after the first shot.
18. Prostate cancer screenings: covers digital rectal exams and prostate specific antigen (PSA) blood tests once every 12 months for men over 50 (starting the day after your 50th birthday).
19. Sexually transmitted infection screenings & counseling: covers screenings for chlamydia, gonorrhea, syphilis, and/or Hepatitis B if you’re pregnant or at increased risk for an STI. Medicare also covers up to 2 individual 20-30 minute, face-to-face, high-intensity behavioral counseling sessions if you’re a sexually active adolescent or adult at increased risk for STIs. Medicare covers these tests once every 12 months or at certain times during pregnancy. Medicare covers behavioral counseling sessions once each year. 20. Coronavirus disease 2019 (COVID-19) vaccine: covers FDAauthorized COVID-19 vaccines. Vaccine helps reduce the risk of illness from COVID-19 by working with the body’s natural defenses to safely develop protection (immunity) to the virus.
Things to know:
If you’re immunocompromised (like people who have had an organ transplant and are at risk for infections and other diseases), Medicare will cover an additional dose of the COVID-19 vaccine at no cost to you.
You may be able to get the COVID-19 vaccine in your own home.
Be sure to bring your red, white, and blue Medicare card so your health care provider or pharmacy can bill Medicare. You’ll need your Medicare card even if you’re enrolled in a Medicare Advantage Plan.
If you fill out a form to get the vaccine, you may be asked for your insurer’s group number. If you have Part B, leave this field blank or write “N/A.” If you have trouble with the form, talk with your vaccine provider.
Medicare also covers COVID-19 tests, COVID-19 antibody tests, and COVID-19 monoclonal anti body treatments.
21. Counseling to prevent tobacco use & tobacco-caused disease: covers up to 8 visits of smoking and tobacco-use cessation counseling visits in a 12-month period smoking if you use tobacco. Cost to preventive services: None for Medicare part beneficiaries
Note: Your doctor or other health care provider may recommend you get services more often than Medicare covers. Or, they may recommend services that Medicare doesn’t cover. If this happens, you may have to pay some or all of the costs. Ask questions so you understand why your doctor is recommending certain services and whether Medicare will pay for them.
As your health advocate, it is important for me that you know what your benefits are and when to use them. The more information you know, the better care and treatment you will receive. If there is any cloud of doubt with coverage, call your healthcare provider to get the right information or call MEDICARE @ 1-800-MEDI-CARE. Always wishing you good health, Melody Dizon, RN
