Does Medicare Cover Preventive Care?

Medicare covers a wide variety of preventive care treatments, and you can find Medicare doctors who specialize in senior healthcare at Oak Street Health centers. Keep reading to understand more about the importance of preventive care for older adults, and the types of treatments you can expect to be covered through your Medicare plan.

What Is Preventive Care?

Preventive care is focused on keeping people healthy. By reducing the risk of disease, injury, and illness, preventive care improves your quality of life and keeps down healthcare costs. Some examples of preventive services include:

  • Flu shots
  • Pap tests
  • Screening mammograms

Medicare Preventive Care Coverage

Most preventive care services are covered by Medicare, as long as your healthcare provider accepts Medicare. At Oak Street Health, all our doctors and other healthcare professionals take Medicare, Medicaid, Medicare Advantage, and Medigap plans, so you don’t have to worry about your preventive care needs being met.

Welcome to Medicare Visit

During the first 12 months that you have Medicare, you’re entitled to one “Welcome to Medicare” preventive visit. It includes a review of your health history. You’ll also receive information and advice about preventive services, such as screenings and vaccines. If you need further care, you’ll get a referral.

Your visit may also include:

  • Height, weight, and blood pressure measurements
  • A simple vision test
  • A review of any potential risks for depression
  • Discussion of advance directives—legal documents that record your wishes about medical care, in case you’re ever unable to make decisions for yourself in the future

Yearly Wellness Visit

After you’ve had Medicare for longer than 12 months, you get one wellness visit per year. At this visit, you’ll fill out a questionnaire called a Health Risk Assessment. Based on your answers to the questions, your Oak Street Health provider will create or update a personalized plan to help you stay healthy.

Your provider may also do a cognitive impairment assessment—a quick check for possible signs of Alzheimer’s disease or dementia. In addition, your provider will review which screenings and vaccines are due and make any referrals you might need.

Preventive care is an often overlooked but crucial piece of the healthcare puzzle when it comes to keeping you as healthy as possible. For any preventive care services Medicare does provide for you, take advantage of them. These services usually will not cost you anything and could greatly enhance your life.

Routine Physical Exam

A routine physical exam is a hands-on checkup. The provider examines your body to determine the state of your health using touch, sight, listening, and other techniques. Unlike the “Welcome to Medicare” visit or yearly wellness visit, however, Medicare does not cover routine physical exams. (They are covered by some Medicare Advantage plans.) These types of visits can often be confusing, so make sure you know which one you’re scheduling so you don’t receive a surprise bill.

Medicare Preventive Care Examples

Medicare covers several preventive care services. Sometimes you must meet certain eligibility requirements to qualify. Some of the preventive services that may be covered include:

  • Alcohol misuse screening and four counseling sessions
  • Bone density measurement
  • Cardiovascular disease screenings (including cholesterol, lipid, lipoprotein, and triglyceride levels)
  • Cervical and vaginal cancer screenings (Pap test and pelvic exam)
  • COVID-19 vaccines
  • Flu shots
  • Obesity screening and behavioral therapy sessions
  • Pneumonia vaccines
  • Prostate cancer screening

If you have questions about whether certain preventive care services are covered under Medicare, talk with your Oak Street Health doctor or consult the “Medicare & You” handbook.

The Lower Costs of Preventive Care

Less than half of adults age 65 and older are up to date with the recommended preventive health services. This is important to stay on top of because preventive care can help lower health risks, reduce the costs of treating chronic disease, and prevent or delay the onset of disease. People who have preventive care are less likely to need to visit the hospital, which can be a major expense.

How Preventive Care Works

How does preventive care lead to better health? Preventive care is proactive instead of reactive—that means you’re taking your wellness into your own hands instead of waiting for something to go wrong.

There are a few different times when proactive care can really make a difference:

  • Before disease occurs (for example, a flu vaccine that prevents you from getting sick)
  • In the early stages of disease (for example, a screening that catches cancer near the beginning, when it’s easiest to treat)
  • After the disease is established (for example, diabetes self-management training that helps you manage your diabetes through eating healthy, getting exercise, monitoring your blood sugar, and taking your medicine as prescribed)
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Get the Most Out of Medicare

Preventive care is the cornerstone of what we do at Oak Street Health in Philadelphia. It is an often overlooked but crucial piece of the healthcare puzzle when it comes to keeping you as healthy as possible. For any preventive care services that Medicare does provide, take advantage of them. These services usually will not cost you anything and could greatly enhance your life.