Medicare Your Coverage Options

Get the preventive care you need: Medicare pays for it

Written by Diane Archer
Preventive care is very important, especially as you age.  As you get older, vision, hearing and balance should be checked annually. And, you should get a flu shot every year as well.  Fortunately, Medicare now pays for many of these services in full, as well as an annual wellness visit.  Medicare covers some tests annually and others every few years.

Cost:  Medicare covers the full cost of many, but not all, preventive services.  If you have traditional Medicare, for full coverage, you will need to see a doctor who takes assignment, a “participating provider,” who accepts Medicare’s approved rate as payment in full.  Fortunately, the vast majority of doctors accept assignment.  If the doctor finds a problem and needs to do more tests, you may have to pay a deductible or coinsurance for those services.  If you are in a Medicare Advantage plan, for full coverage, you will need to see an in-network doctor.

Medicare covers 100 percent of the cost of the following services:

Medicare covers 80 percent of the cost of the following services:

  • glaucoma, trainings for diabetes self-management,
  • barium enemas to detect colon cancer, and
  • digital rectal exams to detect prostate cancer.

Keep in mind that health care screenings can have risks. Screenings may turn up issues that warrant addressing; they also may turn up issues that would be best left alone. If the screening results turn up something out of the ordinary, doctors often do not know whether there is a problem that should lead to more tests or a surgery. For example, a breast screening may reveal a possible tumor, but the tumor may be best left untouched because it will never grow large or present a health risk. It should not be removed. The risk to you can come from removing a tumor that does not present a health risk. Surgery involves its own set of risks, including bacterial infections. The US Preventive Services Task Force, an independent panel of experts in primary care and prevention, recommends certain preventive care services, and it does not recommend others, based on the evidence of effectiveness.

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