12 Things a Medicare Health Plan Covers
Medicare is a government health insurance program that covers people over 65, some younger people with disabilities, and those with end-stage renal disease. It has four parts – Part A, which covers hospital insurance, nursing facilities, hospice, and in-home care; Part B, which covers doctor’s visits, outpatient care, medical equipment, home healthcare, and preventive screenings; Part C, which offers Medicare-approved plans by private companies, and Part D, which covers the cost of prescriptions.
Due to the complex nature of federal policies, there are several things that we tend to skip. Learning about them can help you make better and more efficient policy use. So, here are the 12 things that fall under a Medicare coverage:
Welcome to Medicare preventive visit
Enrolling for Medicare makes you eligible for a ‘Welcome to Medicare’ preventive visit. Although essential, this service is often overlooked by many people. It is meant to allow you to meet with your primary care physician for an overall check-up, establish a baseline for your health, and create a health and wellness plan for the upcoming year. Here, you can discuss your medical history, examine your need for treatment, and formulate a plan for a healthier future.
Yearly wellness visits
In addition to a welcome visit, you also get annual wellness visits which are the opportunity to have a scheduled check-up and to talk to your healthcare provider about your yearly care plan. This is certainly not the only time you can visit the doctor. It is a special appointment addressing your overall health and concerns.
Counseling to battle lifestyle changes
If you’re trying to make lifestyle changes that severely impact your health, you can avail of behavioral counseling services under Medicare Part B. For some people, Medicare may also cover yearly lung cancer screenings to keep track of their health, detect abnormalities early, and curate a more effective treatment plan.
Influenza, or the common flu, can be a severe health risk for some seniors. Medicare also covers flu shots to help build immunity against it, which can be received at the doctor’s office or the local pharmacy. Ensure you follow safe hygiene practices, such as washing your hands frequently to remain healthy, especially during flu season.
Nutrition therapy services
People with diabetes and kidney disease also qualify for nutrition therapy services. Here, you can receive professional help to establish a lifestyle change and build a nutrition plan that meets your requirements.
Covid vaccines, tests, and treatments
Covid-19 emerged as a significant threat to seniors in the last few years. To reduce the risk, Medicare covers vaccinations and boosters, PCR and antibody tests, and monoclonal antibody treatments to give seniors a better chance for recovery.
Gender-specific cancer screenings
Medicare also covers gender-specific cancer screenings. This includes annual prostate cancer screenings using the prostate-specific antigen (PSA) test among men. For women, this annual service includes screening mammograms and PAP smears. Please note that digital rectal programs and diagnostic mammograms do not fall under this category and may be charged as per your Medicare coverage.
Diabetes self-management training
Those who have recently received a diabetes diagnosis are also eligible for diabetes self-management training (DSMT). Medicare coverage covers up to 80% of DSMT appointments for up to 10 hours, along with two hours of follow-up appointments when necessary. This program helps people learn how to manage their daily lifestyle, such as eating healthy, being active, monitoring blood sugar levels, administering insulin, and reducing the risk of a blood sugar imbalance to cope better with the disease.
Special footwear for people with diabetes
Many people with diabetes may also develop a condition called neuropathy, which can cause numbness, weakness, and pain in the hands and feet. One of the recommendations for keeping the feet safe is to use footwear explicitly designed for this condition. After a visit with a Medicare-approved podiatrist, people with diabetes may be eligible for up to 80% coverage for one pair of special shoes and up to two inserts per year.
Colorectal cancer screenings
Medicare also includes several forms of colorectal cancer screenings, such as multi-target stool DNA tests, colonoscopies, screening barium enemas, fecal occult blood tests, and flexible sigmoidoscopies. People who are at an average risk of developing this condition are eligible for at-home multi-target stool DNA tests once every three years. Colonoscopies are also covered under this program. People with a higher risk of colorectal cancer are eligible for a colonoscopy once every two years. This period may vary for others with a lower predisposition to the condition.
Adjusting to retirement years is a major lifestyle change, which may bring about several emotional reactions among seniors, such as depression. To address these concerns, Medicare covers annual depression screenings at no extra cost. Here, you begin with meeting your primary care physician to recognize any emotional signs of depression. Depending on your requirements, the doctor may recommend visiting a psychologist or psychotherapist.
Limited vision and dental coverage
Most people believe Medicare does not cover dental or vision-related expenses at all. That isn’t true. Although cleanings, extractions, and fillings are not covered under federal Medicare, you may be covered for certain dental services or emergency dental procedures during your stay at a hospital. People with glaucoma and macular degeneration may also have coverage for eye exams. If you’re keen on getting these benefits, you may want to consider signing up for some Medicare Advantage or Medicare Cost plans. Some Medicare Advantage plans also offer hearing care, which may cover the partial or complete cost of hearing aids.
Besides these benefits, Medicare also covers various medical screening for conditions such as abdominal aortic aneurysms, cardiovascular diseases, hepatitis B, hepatitis C, lung cancer, and several sexually transmitted diseases.