Medicare Preventive Services

Medicare has expanded covered Preventive Services in the past several years. You’re no longer limited to one “Welcome to Medicare” Physical when you first enroll.

There are some differences between your coverage before Medicare (your group insurance through your employer or an individual plan purchased from Covered California or directly from an insurance carrier).

For example, Mammograms and Pap Tests are generally covered on an annual basis before you qualify for Medicare.  Once Medicare is your primary coverage, Paps may only be covered every 24 months (unless you’re considered “high risk”) while Mammograms continue to be covered every 12 months.

Blood Pressure screening is covered every 12 months, but tests for Cholesterol, Lipid, and Triglyceride levels are covered once every 5 years.  Of course, if you’re currently taking a cholesterol lowering medication, for example, your doctor will want to monitor results on a more frequent basis.  In that case, your doctor will code the test not as “preventive”, but to reflect that your ongoing condition is being monitored, which will generally be covered by Medicare annually (or more frequently if medically necessary).

Medicare has  prepared a booklet to explain their Preventive services, which you may download from their website or review here:  Medicare Preventive Services

Call us with questions at 831-335-8200!