New Medicare Preventive Services Benefits — Free ! (Maybe)

New Medicare Preventive Services Benefits — Free ! (Maybe)

Seniors are reporting that in recent years they have frequently put off visits to the doctor and other healthcare providers due to economic reasons, according to recent TSCL surveys.  You may have been told that the new healthcare reform law provides “free” new preventive benefits.  While that made a good sound bite for the TV news and those Andy of Mayberry ads, the reality is most Medicare beneficiaries will probably still have some out-of-pocket costs.  In order to qualify for the “free” preventive services you need the following:

• To get your health services through Original Medicare.  If you are enrolled in a Medicare Advantage plan, deductibles and co-pays may apply to these preventive services.  Check with your plan to see what costs and rules apply.

• Your doctor or provider accepts “assignment” or the Medicare approved payment, as payment in full.  There may be some doctors in your area that accept assignment, but fewer do that anymore.  You will need to call your doctor  to find out if he or she accepts assignment.  Many are charging more than the Medicare-approved amount and you or your Medigap plan will need to cover the “excess” charges.  Even if you do locate a doctor who accepts assignment, a growing number of doctors are not accepting new Medicare patients.  To find a doctor who accepts assignment call the customer service number of your Medigap supplement.  Then call the physician to find out if he or she is accepting new Medicare patients.

• Services must be those that have earned an “A” or “B” recommendations by the U.S. Preventive Services Task Force.  They include: annual wellness visit, blood tests for heart disease, bone mass measurements, diabetes screening, colon cancer screening, diabetes screening, flu shot, hepatitis B vaccine, medical nutrition therapy, pap smears, pelvic exams and clinical breast exams, pneumonia vaccine, prostate cancer screening (PSA test), and screening mammograms.

• You must follow Medicare guidelines for receiving the services to ensure coverage.  Find out how often you should receive a service.  Some preventive services are covered only once every few years, others are covered only if you meet specific criteria.  To learn more read “Your Guide to Medicare’s Preventive Services,” CMS Product No. 10110.  Download a copy at or call 1-800- Medicare (1-800-633-4227).