These services could save you money and help prevent several
expensive conditions.
Brandon
Ballenger • April 28, 2019
If you
have Medicare or will soon, you probably know the basics of what it covers. But
how much do you know about all the lesser-known benefits that are included with
Medicare health insurance coverage?
They
aren’t exactly free, because Medicare isn’t
free. But these included services have no out-of-pocket costs for
many Medicare beneficiaries.
There
are some caveats. For example, there may be limitations on frequency, and your
health care provider must accept Medicare’s payment conditions. Still, it’s
worth knowing these benefits are in your pocket if you have Original Medicare,
which is one of the two main types of Medicare plans.
Costs
may differ for Medicare Advantage plans — the other main type of Medicare plan
— because they are offered by private insurers and generally come with their
own set of benefits, as we explain further in “7 Facts You Need
to Know About Medicare.”
1. Annual wellness visit
The
purpose of the annual wellness
visit is to develop or update a personalized plan to help
prevent disease and disability based on your health situation.
According
to Medicare.gov, the official government website for Medicare, the visit might
also include:
- A review of your medical and
family history
- Developing
or updating a list of your health care providers and prescriptions
- Routine
measurements — such as height, weight and blood pressure
- Detection
of cognitive impairment
- Personalized
health advice
Just
note that costs such as a deductible might apply if during an annual visit you
receive additional tests or services that aren’t covered preventive benefits.
2. Counseling
The
following types of counseling are among those covered by Medicare for people
who meet eligibility requirements:
- Alcohol
counseling — up to four sessions per year
- Smoking and
tobacco counseling — up to eight sessions in a 12-month
period
- Cardiovascular
behavioral therapy visits — one per year
While
the first two types of counseling are intended to help a patient quit alcohol
or tobacco, which are moves with extensive health benefits, cardiovascular
behavioral therapy is targeted at helping you lower your risk of developing
heart disease.
“During therapy, your doctor may discuss
aspirin use (if appropriate), check your blood pressure, and give you tips to
make sure you’re eating well,” says Medicare.gov.
3. Screenings
Medicare
covers screenings for a variety of health conditions. They include screenings
for:
- Cardiovascular
disease — one blood test every five months
- Colorectal
cancer — one colonoscopy every 24 or 120 months, depending
on your risk
- Depression —
one screening per year
- Diabetes —
up to two screenings per year
Some
screenings have eligibility requirements, while others do not.
4. Vaccines
One influenza shot per
flu season is free.
A total
of two pneumococcal
shots are also covered. These vaccines protect against
pneumococcal disease, which the U.S. Centers for Disease Control and Prevention
describe as any type of infection caused by Streptococcus pneumoniae bacteria.
Vaccines
for hepatitis B may
also be covered, depending on your risk.
5. The ‘What’s Covered’ app
Medicare
recently debuted a free app called “What’s Covered,”
which is available for Apple and Android devices. You can use the app to look
up other items and services and find out whether Medicare covers them.
“The
app delivers general cost, coverage and eligibility details,” says
Medicare.gov.
If you
don’t want to download the app or don’t have a smartphone or internet-connected
tablet, you can use a computer to access Medicare.gov’s Your Medicare Coverage tool, which also
lets you search for an item or service and find out whether it’s covered.
6. Insurance assistance
People
who are eligible for Medicare as well as their families and caregivers have
access to free in-depth, one-on-one insurance counseling and assistance from
State Health Insurance Assistance Programs (SHIPs)
SHIPs
are funded by grants that the U.S. Department of Health and Human Services
(HHS) makes to states, according to the
HHS Administration for Community Living. There is a SHIP for every state as
well as the District of Columbia, Puerto Rico, Guam and the U.S. Virgin
Islands.
SHIPs
can be especially helpful during open enrollment season, although they offer
various other services besides one-on-one assistance with reviewing your
Medicare plan options. They can also:
- Answer questions about what
Medicare does and does not cover.
- Tell
you about out-of-pocket cost assistance programs for which you might be
eligible.
- Help
you understand Medicare’s eligibility criteria.
- Explain
how Medicare coverage works in conjunction with supplemental insurance
policies, Medicaid and other forms of health insurance.
To find
the SHIP for your state, visit the
national SHIP website or call 877-839-2675.
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