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Annual Wellness Screening

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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:

1. Abdominal aortic aneurysm screenings: You’re considered at risk if you have a family history of abdominal aortic aneurysms, or you’re a man 65-75 and have smoked at least 100 cigarettes in your lifetime. Allowed once in a lifetime.

2. Alcohol misuse screenings & counseling: If your primary care practi tioner determines you’re misusing alcohol, you can get up to 4 brief faceto- face counseling sessions each year (if you’re competent and alert during counseling). Allowed once each year.

3. Bone mass measurements: Measurements are done once every 24 months (or more often if medically necessary) if you meet one of more of these conditions:

• You’re a woman whose doctor determines you’re estrogen deficient and at risk for osteoporosis, based on your medical history and other findings.

• Your X-rays show possible osteoporosis, osteopenia, or vertebral fractures.

• You’re taking prednisone or steroid-type drugs or are planning to begin this treatment. • You’ve been diagnosed with primary hyperparathyroidism.

• You’re being monitored to see if your osteoporosis drug therapy is working.

4. Cardiovascular disease screenings: Blood test screenings are allowed once every 5 years – cholesterol, lipid, and triglyceride levels that help detect conditions that may lead to a heart attack or stroke.

5. Cardiovascular behavioral therapy: Allows visit one time each year with your primary care doctor that helps lower your risk for cardiovascular disease. During therapy, your doctor may discuss aspirin use (if appropriate), check your blood pressure, and give you tips on eating well.

6. Cervical & vaginal cancer screenings: covers Pap tests and pelvic exams to check for cervical and vaginal cancers. It also covers clinical breast exam to check for breast cancer. Medicare covers these screening tests once every 24 months. If you’re at high risk for cervical or vaginal cancer, or if you’re of child-bearing age and had an abnormal Pap test in the past 36 months, Medicare covers these screening tests once every 12 months. Part B also covers Human Papillomavirus (HPV) tests (as part of a Pap test) once every 5 years if you’re age 30-65 without HPV symptoms.

7. Colorectal cancer screenings Multi-target stool DNA tests: Medicare covers this at-home multi-target stool DNA lab test once every 3 years if you meet all of these conditions:

• You’re age 50-85. You show no symptoms of colorectal disease including, but not limited to one of these:

• Lower gastrointestinal pain, Blood in stool, Positive guaiac fecal occult blood test or fecal immunochemical test

• You’re at average risk for developing colorectal cancer, meaning:

– You have no personal history of adenomatous polyps, colorectal cancer, or inflammatory bowel disease, including Crohn’s Disease and ulcerative colitis.

– You have no family history of colorectal cancers or adenomatous polyps, familial adenomatous polyposis, or hereditary nonpolyposis colorectal cancer.

Colonoscopies: Allowed once every 24 months if you’re at high risk for colorectal cancer. If you aren’t at high risk for colorectal cancer, Medicare covers the test once every 120 months, or 48 months after a previous flexible sigmoidos copy. There’s no minimum age requirement.

8. Depression screenings: covers one screening per year. The screening must occur in a primary care setting (like a doctor’s office) that can provide follow-up treat ment and/or referrals.

9. Diabetes screenings: covers glucose laboratory test screenings (with or without a carbohydrate challenge) if your doctor deter mines you’re at risk for developing diabetes. You may be eligible for up to 2 screenings each year. Part B covers these lab tests if you have any of these risk factors:

High blood pressure (hypertension), History of abnormal cholesterol and triglyceride levels (dyslipidemia), Obesity, A history of high blood sugar (glucose)

Medicare also covers these screenings if 2 or more of these apply to you:

• You’re age 65 or older. You’re overweight. You have a family history of diabetes (parents or siblings). You have a history of gestational diabetes (diabetes during pregnancy) or delivery of a baby weighing more than 9 pounds.

10. Flu shots: People who are 65 and older are at high risk of having serious health complications from the flu. Getting the flu shot protects you from getting the flu and keeps you from spreading it to others. Medicare covers one flu shot per flu season.

Things to know

– Don’t wait to get the flu shot. You can get the flu shot many places, including your doctor’s office and your local pharmacy — contact them for details. If you have a Medicare Advantage Plan, contact your plan — most places accept Medicare Advantage Plans.

– Stay safe. Your doctors and pharmacies are working hard to keep you safe and socially distanced. Remember to wear your mask when you get your shot.

11. Glaucoma tests: covers glaucoma tests once every 12 months if you’re at high risk for the eye disease glaucoma. You’re at high risk if one or more of these applies to you:

You have diabetes. You have a family history of glaucoma. You’re African American and age 50 or older. You’re Hispanic and age 65 or older.

12. Hepatitis B shots: covers these shots if you’re at medium or high risk for Hepatitis B. Your risk for Hepatitis B increases if one of these applies:

You have hemophilia. You have End-Stage Renal Disease (Esrd). You have diabetes. You live with someone who has Hepatitis B. You’re a health care worker and have frequent contact with blood or bodily fluids. Other factors may also increase your risk for Hepatitis B. Check with your doctor to see if you’re at high or medium risk for Hepatitis B.

13. HIV screenings: covers an HIV (Human Immunodeficiency Virus) screening once per year if you meet one of these conditions:

You’re age 15-65. You’re younger than 15 or older than 65 and are at an increased risk for HIV. If you’re pregnant, you can get the screening up to 3 times during your pregnancy.

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

(To be continued on next issue)

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