Medicare and Preventive Services

When you enroll in Medicare you will receive the Medicare and You booklet outlining the services that are available to you. A list of covered preventive services can be found in section 3. We encourage you to use this list to keep track of the services you have received. You can also request this booklet at www.medicare.gov.  Medicare provides you with services that will keep you healthy and help you manage your existing health concerns. The majority of these preventive services, including “Wellness” visits are covered at little to no cost to you.

What’s covered?

We recommend that you speak with your primary care physician during your annual “Wellness” visit to discuss which of these services, screenings, or counseling sessions are most appropriate for managing your health.

Vaccinations

  • Flu Shot – received 1 time per season
  • Hepatitis B shots – 1 time
  • Pneumococcal shot – 1 time

Routine screenings for:

  • Abdominal Aortic Aneurysm – 1 time
    • Ultrasound assessment
  • Bone Density – 1 time every 24 months
    • Radiology assessment
  • Breast Cancer – 1 time every 12 months
    • Mammography
  • Cardiovascular Disease – 1 time every 5 years
    • Blood test
  • Cervical and Vaginal Diseases – 1 time every 24 months
    • Pap tests and pelvic exams
  • Colorectal Cancer
    • Fecal Occult – 1 time every 12 months
    • Flexible Sigmoidoscopy – 1 time every 4 years, or every 10 years after first exam if low risk
    • Colonoscopy – 1 time every 10 years or 48 months after first sigmoidoscopy
    • Barium Enemas – 1 time every 4 years, or every 2 years for high risk patients who do not receive a colonoscopy or sigmoidoscopy
      • Patients are responsible for paying 20% of the Medicare-approved amount for this service, plus the Part B deductible
  • Diabetes – 2 times per year if at risk
    • Blood test
  • Glaucoma – 1 time every 12 months for high risk patients
    • Eye exam
      • Patients are responsible for paying 20% of the Medicare-approved amount for this service, plus the Part B deductible
  • Human Immunodeficiency Virus (HIV) – 1 time every 12 months
    • Blood test
  • Sexually Transmitted Diseases (STD) – 1 time every 12 months
    • Blood test and physical exam
  • Prostate Cancer – 1 time every 12 months
    • Blood test and Digital Rectal Exam
      • Patients are responsible for paying 20% of the Medicare-approved amount for the rectal exam, plus the Part B deductible

Behavioral and Mental Illness Screening and Counseling for:

  • Alcohol Misuse – 1 time every 12 months
    • 4 counseling sessions per year with a primary care physician
  • Cardiovascular Disease (behavioral therapy) – 1 time every 12 months
    • 1 to 1 discussion with your physician
  • Depression – 1 time every 12 months
    • Screening test performed by your doctor
  • Diabetes Self-maintenance – 1 time
    • Outpatient program
      • Patients are responsible for paying 20% of the Medicare-approved amount for this service, plus the Part B deductible
  • Medical Nutrition Therapy – 1 time
    • Counseling and nutrition assessment
    • Available for patients with diabetes, kidney disease, or who have undergone a kidney transplant in the last 36 months
  • Obesity – 22-fifteen minute counseling sessions every 12 months
    • Available for individuals with a Body Mass Index (BMI) at or above 30
  • Sexually Transmitted Diseases – 2-twenty to thirty minute sessions every 12 months
    • Behavioral and disease management counseling performed by your primary care physician
  • Tobacco Cessation – 8 counseling sessions every 12 months
    • Sessions are free to patients who smoke and do NOT have a smoking related illness
    • Patients who DO HAVE a smoking related illness are responsible for paying 20% of the Medicare-approved amount for this service, plus the Part B deductible

Allaying the Costs of Preventive Services

Many of the above services are provided at no cost to you. However, some tests and counseling sessions require that patients pay 20% of the Medicare-approved amount for the service, plus the Part B deductible. In addition, your physician may suggest that you receive a service that is not fully covered by Medicare. We advise that you speak with your healthcare provider about these other services, and discover why he or she believes they are medically necessary , and if there are alternatives that Medicare will cover.

The Wooten Agency recommends that you speak with our agents about Medigap  options that will pay the remaining 20% of Medicare-approved costs, of which you are responsible.  We are happy to provide you with a free consultation and answer all of your health insurance questions.

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Medicare and Preventive Services | Wooten Agency

  • "This is a family-owned business who cares about their potential clients. I was looking for help with health insurance and even though it turns out I don't need new health insurance at this time, I feel compelled to write a review because of how thorough Brendan was. He was very knowledgeable and easy-going. He didn't seem pushy at all and listened to everything I had to say. He made sure he was getting all the information correct. I would recommend this agency for any insurance needs." - - Cary, NC
  • "I sought help from Wooten Agency; Ed, along with Nancy, took the bull by the horns and sorted things out for us very quickly. Shortly thereafter Ginny took over. She is definitely most qualified as a plan selector for Medicare plans and issues related to Medicare. My appreciation to Crystal for the gracious way she always responds to telephone calls and makes every effort to ensure one is not forgotten. And Dana....the one contact we had was enough to find out you are similarly inclined to help a client." - - Raleigh, NC
  • "You [Aaron] have been so helpful, and you have all taken a personal interest in my individual and specific questions in order to make the best insurance choices for my needs. Thank you all! I look forward to working together in the future months and years." - - Morrisville, NC

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