Medicare Announces Preventive Services Available for Senior Citizens in 2007

November 2, 2006 – Medicare has released the list of preventive services that will be offered in 2007 to senior citizens enrolled in Medicare Part B. There is at least one addition to the "Welcome to Medicare" initial exam - in 2007, people who are at risk for abdominal aortic aneurysms may get a referral for a one-time screening ultrasound.

	Premiums and Deductibles for 2007
	● Part A Premium: $410 (only paid by about 1%) ● Part A deductible: $992 ● Part B standard premium: $93.50 ● Part B deductible: $131

The monthly Part B premium will be $93.50 in 2007 for the vast majority of senior citizens. For the first time, however, seniors with higher incomes will pay higher rates. Only seniors earning at least $80,000 ($160,000 for couples) a year will be subject to this new surcharge and Medicare says it should only be about four percent of current Part B enrollees. (Click here to earlier news report.)

The standard Medicare Part B monthly premium of $93.50 is an increase of $5.00 or 5.6 percent from the current $88.50 monthly premium.

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Medicare offers a one-time preventive physical exam but it must be within the first six months that a senior has Part B coverage. The exam includes a thorough review of an individual's health, as well as, education and counseling about the preventive services needed, like certain screenings and shots, and referrals for other care.

Medicare will only cover this physical exam if it occurs within the first six months after a senior enrolls Part B.

Medicare says, "If your doctor thinks this six month period has passed, he or she should give you a notice that says Medicare probably won't pay for this service. If you still want to get the service, you will be asked to sign an agreement that you will pay for the service yourself if Medicare doesn't pay for it. This is called an Advance Beneficiary Notice."

Beneficiaries pay 20 percent of the Medicare-approved amount after meeting the yearly Part B deductible ($131 for 2007). Since this for most seniors will be their first Medicare-covered service, it may meet the entire Part B deductible.

Once limited by statute to providing coverage only for diagnosis and treatment of an illness, injury, or impairment of a body part, the Medicare program, through a series of legislative changes, now covers a broad range of preventive and screening services for beneficiaries in Part B.

Below is a list of the Part B covered preventive services for 2007.

For more about preventive services at the Medicare Website - click here.

Service	Who and what is covered?	How often can I get this service?	Do I have to pay coinsurance or deductible?
Flu Shots	All people with Medicare.	Once a flu season, or more frequently if medically necessary.	No coinsurance or deductible.
Pneumococcal Shot	All people with Medicare.	Once in a lifetime	No coinsurance or deductible.
Hepatitis B Shots	People with Medicare who are at medium to high risk.	One series if ordered by a doctor.	Coinsurance and deductible.

Initial Preventive Physical Examination

(The “Welcome to Medicare” physical exam)

All new enrollees in Medicare Part B may receive an exam that includes medical and social history review, and physical examination and electrocardiogram (ECG), with counseling, referral and a written plan for additional preventive services that are needed.

NEW - In 2007, people with Medicare who are at risk for abdominal aortic aneurysms may get a referral for a one-time screening ultrasound at their Welcome to Medicare Physical Exam.

One time only within the first 6 months you have Medicare Part B.

Coinsurance and deductible.

You pay 20% of the Medicare-approved amount with no Part B deductible for the Abdominal Aortic Ultrasound screening.

Cardiovascular Disease Screenings

All people with Medicare Part B may receive assessment of blood lipid levels.

Every 5 years.

No coinsurance or deductible.

Diabetes Screenings

· Those with Medicare with 2 or more of the following: age 65 or older, overweight, family history of diabetes, or a history of gestational diabetes or delivery of a baby weighing more than 9 pounds.

· Those with Medicare who have high blood pressure, dyslipidemia, obesity, or history of high blood sugar may receive a test for elevated blood glucose

· 1 screening per year if you were never tested or if you were previously tested, but not diagnosed with pre-diabetes.

· 2 screenings per year if you are diagnosed with pre-diabetes.

No coinsurance or deductible.

Pap Test and pelvic screening exams	All women with Medicare.	· Every 24 months. · Once every 12 months if you are high-risk or if you are of childbearing age and have had an abnormal Pap test in the past 36 months.	Coinsurance but no deductible for the pelvic exam. Beneficiary pays nothing for the lab analysis.
Screening Mammograms	Women with Medicare who are age 40 or older.	Once every 12 months.	Coinsurance; no deductible.
Screening Mammograms	Women with Medicare who are age 35-39.	One baseline mammogram.	Coinsurance; no deductible.
Colorectal Cancer Screening	People with Medicare age 50 or older except there is no minimum age for a screening colonoscopy or barium enema as an alternative to colonoscopy.	· Fecal occult blood tests once every 12 months · Flexible sigmoidoscopy- every 48 months or once every 120 months after having a screening colonoscopy. · Screening colonoscopy- every 24 months if you are at high risk; every 120 months if you are not at high risk. · Barium enema - every 24 months if you are at high risk; every 48 months if you are not at high risk.	No coinsurance or deductible for fecal occult blood tests. All other tests, coinsurance and deductible. NEW: Starting in 2007, Medicare will waive the Part B deductible for the colorectal screening benefit. Coinsurances still apply.
Prostate Cancer Screening	All men with Medicare over age 50.	Digital Rectal Exam: once every 12 months Prostate Specific Antigen (PSA) Test: once every 12 months	· Coinsurance and deductible for digital rectal exam. · No coinsurance or deductible for Prostate Specific Antigen Test.
Bone Mass Measurements	People with Medicare whose doctors say they are at risk for osteoporosis.	Every 24 months (more often if medically necessary	Coinsurance and deductible.

Glaucoma Tests

People with Medicare who have diabetes, a family history of glaucoma, are African American and age 50 or older, or are Hispanic-American age 65 and over.

Once every 12 months

Coinsurance and deductible.

For more details about these services, get a free copy of the Guide to Medicare’s Preventive Services (CMS Pub. No. 10110) at www.medicare.gov on the web. Select “Publications.” Or, call 1-800-MEDICARE (1-800-633-4227) and ask for a copy. TYY users should call 1-877-486-2048.

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