1. Understanding Your New Medicare Preventive Care Benefits
One-time "Welcome to Medicare" Physical Exam - Medicare does not normally cover routine
physical exams. However, Medicare will cover 80% of the Medicare-approved amount, after meeting the
Part B deductible, of a one-time routine physical examination during the first six months after you
enroll in Medicare Part B regardless of your age. The initial preventive physical exam includes:
• An Electrocardiogram (EKG)
• Measurement of height, weight and blood pressure
• Education, counseling and referral related to other preventive services covered by Medicare
The "Welcome to Medicare" physical exam is a great way to get up-to-date on important screenings
and shots and to talk with your doctor about your family history and how to stay healthy.
Cardiovascular Screening - Medicare covers cardiovascular screenings that check your cholesterol and
other blood fat (lipid) levels. High levels of cholesterol can increase your risk for heart disease and stroke.
These screening tests will tell if you have high cholesterol. You might be able to make lifestyle changes (like
changing your diet) to lower your cholesterol and stay healthy. Medicare will cover these tests every five
years. Medicare will pay 100% of its approved amount for these tests. No Part B deductible is required
for these services.
Breast Cancer Screening (Mammograms) - Breast cancer is the most common non-skin cancer in
women and the second leading cause of cancer death in women in the United States. Every woman is at risk,
and this risk increases with age. Breast cancer can usually be successfully treated when found early. Medicare
covers screening mammograms and digital technologies for screening mammograms to check for breast
cancer before you or a doctor may be able to feel it. Medicare covers 80% of the cost of one screening
mammogram a year (every 12 months) for women 40 years and older. Medicare will also pay for one
baseline mammogram for women 35 to 39 years of age. No Part B deductible is required for these
services.
Cervical and Vaginal Cancer Screening (Pap Test and Pelvic Exam) - Pap smears can detect
cervical or vaginal cancer in its early stages. Medicare covers 100% of the cost of one pap smear lab test
every 2 years (24 months) for all women with Medicare (it covers the usual 80% of the doctor visit to
collect the pap smear). If you are considered at high-risk for cervical or vaginal cancer (e.g. have had a
sexually transmitted disease, your mother was given the drug diethylstilbestrol (DES) during pregnancy), or
are of childbearing age and have had an abnormal Pap test in the past 36 months, Medicare will cover the cost
of one pap smear a year (every 12 months). When you get your pap smear, Medicare will also pay 80% of
the cost of a pelvic exam and a clinical breast exam. Medicare will cover all of these services with no
Part B deductible required.
Colon Cancer Screening (Colorectal) - Colon cancer is the third most common form of cancer for
men and women in the United States, and regular screenings can help prevent serious illness. If you are 50 or
older, you are eligible for the following screenings:
• Fecal occult blood test - once a year (every 12 months)
• Flexible sigmoidoscopy - once every four years (48 months)
• Colonoscopy - once every two years (24 months) if you are at high-risk for colorectal cancer
(e.g. have a family history of the disease or have had colorectal polyps), or once every 10 years
if you are not at high-risk (but not within 48 months of a screening flexible Sigmoidoscopy)
• Barium enema - this service is not covered if performed in addition to the other tests
Medicare will cover these services after you pay your annual Part B deductible. Medicare will cover
100% of the cost of the fecal blood test. For the other tests, Medicare will pay 80% of the cost. Medicare
will cover 75% of the cost of a colonoscopy or flexible sigmoidoscopy if the procedure is done in an

2. ambulatory surgical center or hospital outpatient department.
Prostate Cancer Screening (PSA) - Prostate cancer screenings can detect early prostate cancer, the
second most common form of cancer in American men. Medicare covers one prostate screening a year
(every 12 months) for men age 50 and older. This includes a Prostate-Specific Antigen (PSA) blood test
and a Digital Rectal Exam. Medicare will cover these services more than once a year if your doctor says
you need them for diagnostic purposes. Medicare covers 80% of the cost of the Digital Rectal Exam,
after you pay your annual Part B deductible, and 100% of the cost of the PSA test with no Part B
deductible required.
Shots (Flu, Pneumococcal, Hepatitis B)
• Flu Shot - Medicare will cover 100% of the cost of an annual flu shot (every 12 months) in the
fall or winter, with no Part B deductible required, if you go to a doctor who accepts assignment. If
you are in a Medicare HMO, you must see your Primary Care Physician (PCP) for your flu shot, and
you may have a co-pay for this service.
• Pneumonia Vaccine - If you are 65 or older and have a chronic lung condition such as emphysema or
asthma, or your immune system is compromised, Medicare will cover 100% of the cost of your
pneumonia vaccine with no Part B deductible required. You should only need this once in your
lifetime. Ask your doctor.
• Hepatitis B Vaccine - If you are at high-risk for Hepatitis B (e.g., you have kidney failure or travel to
countries with high rates of the disease), Medicare will cover 80% of the cost of your Hepatitis B
vaccine after you pay your annual Part B deductible. If you are in a Medicare HMO, you may have
a co-pay for this service.
Bone Mass Measurements - Bone mass measurements indicate whether you need medical treatment for
osteoporosis, a condition that causes "brittle bones" in many women. If you are considered at risk for
osteoporosis (e.g. have a family history of the disease, have certain conditions, such as thyroid disorders, or
have taken certain medications for a prolonged period of time, such as steroid anti-inflammatories), Medicare
will cover 80% of the cost of one bone mass measurement every two years (24 months), after you pay
your annual Part B deductible. Medicare will also cover follow-up measurements if you doctor
prescribes them.
Diabetes Screening, Supplies, and Self- Management Training – Medicare will cover a blood
test to screen people at risk for the disease. You are eligible for a Medicare-covered diabetes screening every
12 months if you have:
• Hypertension;
• Dyslipidemia (a metabolism disorder);
• A prior blood test showing low glucose (sugar) tolerance; or
• At least two of the following:
o Being overweight;
o Having a family history of diabetes;
o Having a history of diabetes during pregnancy (gestational diabetes) or having had a baby over
nine pounds; or
o Being 65 years of age or older.
Medicare will pay for 100% of its approved amount for the test even before you have paid the Part B
deductible.
Diabetes Self-Management Training, Foot Care and Supplies - If you have diabetes and your
doctor says that you need diabetes self-management training and education, Medicare will cover 80% of the
cost of these services after you pay your annual Part B deductible. You can get up to 10 hours of self-
management training for your first year, and 2 hours every year thereafter.

3. Medicare will also pay 80% of the cost for certain diabetic supplies, such as glucose monitors, lancets,
and test strips, after you pay your annual Part B deductible. You can get these benefits even if you don't
use insulin. If you do use insulin, you can get Medicare-coverage of insulin through the new Medicare
outpatient prescription drug benefit (Part D). Diabetics with peripheral neuropathy may also receive
Medicare-covered foot care once every six months, as long as they have not seen a foot-care specialist for
another reason between visits. Medicare will cover 80% of the Medicare-approved amount after the
yearly Part B deductible. People with diabetes may also qualify for Medicare-covered medical nutritional
therapy.
Glaucoma Tests - Medicare covers 80% of the cost of an annual (every 12 months) glaucoma
screening if you are at high-risk for glaucoma (if you have diabetes or high blood pressure, a family
history of glaucoma, are an African American age 50 and older, or a Hispanic Americans age 65 and
older), after you pay your annual Part B deductible. An eye doctor who is legally allowed to do this
service in your state must do the screening.
Medical Nutritional Therapy - Medical nutritional therapy, which may include diet counseling, is
designed to help you learn to eat right so you can better manage your illness. With a doctor’s referral,
Medicare will cover 80% of the cost of medical nutritional therapy for people with diabetes, chronic
renal disease, or who are post-kidney-transplant patients, after you pay your annual Part B deductible.
Medicare will generally cover 3 hours of medical nutritional therapy for the first year and 2 hours every year
thereafter, although it will cover more hours if your doctor says you need them. In order to have them covered
by Medicare, you must get these services from a registered dietitian or other qualified nutrition professional.
Talk to your doctor if you think you qualify for this benefit.
Smoking Cessation Counseling – Up to 8 sessions per year are covered for those with an illness caused
or complicated by tobacco use or for those who take medications affected by tobacco use. Covers inpatient or
outpatient as well as intermediate or intensive counseling. Part D can help pay for nicotine patches.
Remember that a Medicare supplement will only supplement what Medicare pays. So as a general rule
if Medicare is paying 80%, then the supplement will pick up the other 20%. If Medicare doesn’t pay
then the supplement will not pay.
Prevent Medication Errors
Did you know that most prescription drugs have three different names, including a chemical, generic
(nonproprietary) and brand (proprietary) name? Governed by different rules and regulations, many of these
names sound or appear the same, which has led to 1.5 million medication errors each year, according to
a report released last month by the Institute of Medicine of the National Academies. It does not help that there
are also abbreviations, acronyms, dosage designations and other symbols used in prescribing medications that
make dangerous mistakes even more likely.
To prevent a potentially fatal medication error, follow these four simple steps:
1) Insist that the doctor print both brand and generic names along with the purpose of the medication
on the prescription.
2) Read it over with your doctor and verbally confirm the name and strength of your prescription
before leaving the doctor's office and verify the information with your pharmacist before taking your
medication home. (You also might want to copy the information from the prescription so you can keep
it on file after you give your pharmacist the script.)
3) Double-check your refills to make sure they are correct before leaving the store (if you need to, ring
your old bottle to compare).
4) Share any medical history changes, including the names of all the medications you are taking, with
each of your doctors and your pharmacist before filling any prescription.
John M. Young – Visionary Capital Management – 1-830-609-1990