Preventive care glossary

Preventive care is a key part of meeting your health goals. That’s one reason why it's so important to take advantage of the preventive services covered by Medicare Advantage (MA).

Preventive care and screenings can benefit your health. So you need to know how to take advantage of them. That’s why we’ve compiled a list of some important preventive care services.

The costs of the services described below are generally included in your MA coverage. But you should check your Evidence of Coverage (EOC) document for specific coverage and cost information. Also, remember that even if a procedure is covered by your plan, there can sometimes be an associated out-of-pocket cost.

If your doctor decides they need to follow up on a screening or test, some of the additional procedures may also be covered by your MA plan. Check your health plan documents to determine your level of coverage for follow-up care.

“Your coverage likely includes a wide variety of preventive care options. But they can’t benefit your health if you don’t take advantage of them.”

Cardiovascular disease screenings and behavioral therapy

Heart disease is the leading cause of death for adults over the age of 65, according to the Centers for Disease Control and Prevention. Cardiovascular screenings check your cholesterol and other blood fat (lipid) levels. High levels of cholesterol can increase your risk for heart disease and stroke. This risk-reduction visit covers other tests for heart disease, including screening for high blood pressure. The visit also includes advice on a healthy diet.

Colorectal cancer screenings and associated tests

Colorectal cancer screenings help find precancerous growths in the colon. This means the growths can be removed before they become cancerous. Or they can be treated at an early stage, when treatment works best. A number of different types of tests can be done in a colorectal exam. These include a flexible sigmoidoscopy and FIT testing, which are less invasive than a colonoscopy. As colorectal cancer is a serious health concern, the National Cancer Institute recommends that you get screened annually beginning at the age of 45. Talk to your doctor about how frequently you should be screened.

Diabetes screenings

Your risk of diabetes comes down to three factors: genetics, behavior and age. With Medicare Advantage plans, you’re covered for a blood screening test for diabetes. Check your EOC to determine the number of screenings covered by your plan.

Mammogram screenings

Breast cancer is the most common cancer in women (except for skin cancer), according to the National Institutes of Health. A mammogram is an X-ray that allows a specialist to examine breast tissue for any suspicious areas. MA plans cover one mammogram screening every calendar year for all women age 40 and older.

Prostate cancer screenings

Prostate cancer is the most common cancer in men (except for skin cancer) in the United States, according to the American Cancer Society. Prostate cancer may be found by testing the amount of PSA (prostate-specific antigen) in your blood. Your doctor can also find prostate cancer during a digital rectal exam. Both of these tests are covered once every 12 months for all men over 50.

Flu shots

The flu can be life threatening, so it’s very important to receive an annual flu shot. This is especially true for those who have a chronic illness. Chronic illness includes heart disease, lung disease, diabetes or end-stage renal disease (ESRD). You’re fully covered for one flu shot each flu season (fall and winter).

Lung cancer screenings

MA plans cover annual lung cancer screenings with low-dose CT scan for people who meet several requirements. These requirements include age and a history of smoking, among others. Before your first lung cancer screening, you’ll need to schedule an appointment with your doctor to discuss the benefits and risks of the screening. You can then decide whether it’s right for you.

Depression screenings

Depression screening tests are covered per year when they take place in a primary care setting, like a doctor’s office. These annual screenings are done as part of your “Welcome to Medicare” and annual wellness visits. Your primary care physician (PCP) can provide follow-up on your depression test with treatment and referrals. While depression is a common challenge, it’s not a disease tied specifically to aging. If you experience signs of depression, contact your PCP for a visit.

Glaucoma tests

During a glaucoma test, your ophthalmologist dilates your eyes to view your optic nerve. This helps determine the status of your nerves and detect glaucoma. There are many risk factors for glaucoma. These include diabetes, a family history of glaucoma and more. The best way for people at high risk to protect themselves is to have regular eye exams. MA plans cover glaucoma tests for people at high risk once each year.

Annual wellness visits

All Medicare Advantage plans offer a wellness visit every calendar year at no added cost. This visit is to develop or update a personalized prevention plan based on your current health and risk factors. These annual wellness visits are recommended for everyone. They include many services, such as:

• A review of medical and family history
• Routine measurements like height, weight and blood pressure
• Assessment for any cognitive impairments
• Personalized health advice
• The creation of a screening schedule for appropriate preventive services

 
Remember, there may be costs associated with any follow-up care or additional screenings that result from this visit. Be sure to ask your doctor if they plan to perform additional services that may not be part of your wellness visit. Also, your first annual wellness visit can’t take place within 12 months of either your:

• Enrollment in Original Medicare Part B
• Initial “Welcome to Medicare” visit