During your Welcome to Medicare initial physical exam your doctor will discuss with you the need for certain services. Knowing in advance what to expect takes some of the worry away from transitioning from private health insurance to Medicare.
Print this checklist and take it with you to your doctor.
Initial Wellness Exam – Available to all Medicare beneficiaries if performed within the first 12 months of signing up for Medicare Part B. This is a once in a lifetime benefit. If the exam is performed on or after January 1, 2011 the cost of the exam is covered in full by original Medicare if your doctor accepts Medicare assignment.
Abdominal Aortic Aneurysm Screening – This is a covered expense for Medicare beneficiaries with certain risk factors. This is a once in a lifetime benefit. Copay or coinsurance may apply. Many Medigap plans, including plan F and plan G, will cover the portion of this screening not paid by Medicare.
Bone Mass Measuring – This is a covered expense for Medicare beneficiaries with certain risk factors. This is a once every 24 month benefit. Copay or coinsurance may apply. Many Medigap plans, including plan F and plan G, will cover the portion of this screening not paid by Medicare.
Cardiovascular Screening – This is a covered expense for Medicare beneficiaries with certain risk factors. This is a once every 5 year benefit. No copay or coinsurance applies.
Colorectal Cancer Screening – Medicare beneficiaries age 50 or older may be eligible. For individuals in a “high risk” category there is no minimum age requirement. Fecal occult blood test may be done once every 12 months. Flexible sigmoidoscopy is available once every 4 years. Preventive screening colonoscopy every 24 months if you are high risk, otherwise every 10 years but not within 48 months of a flexible sigmoidoscopy. Your Medicare approved doctor may decide if a barium enema (once every 24 months) can be performed in lieu of a flexible sigmoidoscopy. You pay nothing for a fecal occult blood test. For other tests the Medicare Part B deductible is waived but you may be responsible for copay’s or coinsurance. Many Medigap plans, including plan F and plan G, will cover a portion of this screening that is not paid by Medicare.
Diabetes Screening -This is a covered expense for Medicare beneficiaries with certain risk factors. You receive 2 screening tests per year if you are predisposed to diabetes. You can receive 1 screening per year if previously tested but not diagnosed with pre-diabetes. No deductible , copay or coinsurance will apply.
Diabetes Management Training – This is a covered expense for Medicare beneficiaries diagnosed with diabetes and those at risk for complications of diabetes. You are eligible for up to 10 hours of initial training within a 12 month period. Later years allow up to 2 hours per 12 month period. Medicare Part B deductible, copay and coinsurance applies. Many Medigap plans, including plan F and plan G, will cover a portion of the screening that is not paid by original Medicare.
End of Life Counseling – As of January 7, 2011 HHS (Health and Human Services) have decided to suspend coverage for end of life planning. As part of Obamacare, doctors would recieve additional compensation to discuss how much, or how little care terminal patients may desire. Your doctors may still discuss end of life treatment options, but will not be paid extra to initiate these discussions.
