Medicare Part B includes coverage for many preventive services that can keep you healthy by preventing disease. When these services are performed regularly, they may also catch serious diseases early enough to provide effective treatments and lengthen lifespan. Please discuss procedures with your physician, as some services require physician referrals and oversight.
Medigap Coverage for Medicare Part B Preventive Services
Many of the procedures below fall under Medicare Part B benefits that cover 80% of the cost. Medigap coverage is available to cover the additional out-of-pocket costs from copays, co-insurance or deducibles from the following tests and procedures:
- One-time “Welcome to Medicare” Physical Exam for all people who have had Medicare Part B for 12 months or less
- Cardiovascular Screening (cholesterol, lipid, and triglyceride levels) – once every 5 years
- Breast Cancer Screening (Mammograms) – once a year
- Cervical and Vaginal Cancer Screening – once every 2 years for most women; once a year for those at high risk
- Colorectal Cancer Screening (Fecal Occult – once a year) (Flexible Sigmoidoscopy – once every 4 years) (Screening Colonoscopy – once every 10 years OR 2 years for high-risk OR 4 years after a previous Flexible Sigmoidoscopy)(Barium Enema – once every 4 years OR 2 years for high risk in lieu of sigmoidoscopy or colonoscopy)
- Prostate Cancer Screening (Digital Rectal Examination & PSA Test) – once a year
- Shots (Flu shot – once each flu season in fall or winter) (Pneumococcal Shot – once in a lifetime) (Hepatitis B – doctor must qualify you for them)
- Bone Mass Measurements – once every 2 years (more if medically necessary)
- Diabetes Screening, Supplies, and Self-Management Training (Fasting Blood Glucose Test – up to 2 per year depending on results) (Diabetes glucose monitors, test strips, and lancets – covered) (Diabetes Self-Management Training – upon doctor orders)
- Medical Nutrition Therapy for diabetes or kidney disease – 3 hours of one-on-one counseling services the first year, and 2 hours each year after that
- Glaucoma Tests – once a year
- Smoking Cessation for those diagnosed with a smoking-related illness or are taking medicine that may be affected by tobacco – 8 face-to-face visits in a year
Please check with Medicare Part B guidelines and your physician to ensure you qualify for Medicare Part B preventive services.