Dear Savvy Senior,
Can you give me the recommended health screenings for seniors and which ones Medicare (Part A or B) pays for?
Healthy at 64
Dear 64,
Outside of eating a healthy diet, regular exercise and not smoking, health screenings (tests or examinations that help find health problems early on, when they're easier to treat) are the best way to stay healthy as you age. Here are the key screenings you should be aware of and how they work with Medicare (see www.ahrq.gov/ppip/50plus).
Health Screenings
When you sign up for Medicare (Part B), be sure to take advantage of their one-time “Welcome to Medicare” physical, where all new enrollees can get a thorough physical examination within the first six months. Other important screening tests include:
• Blood pressure checks: More than 65 million American adults (1 in 3) have high blood pressure, a leading cause of stroke and heart attack. Get it checked once a year. More frequent if your pressure is above 130/85.
• Cholesterol checks: Too much cholesterol can clog your arteries and is a major cause of heart disease. Get checked at least every five years, more frequently if you smoke, have diabetes or a family history. (Medicare offers a cardiovascular screenings once every five years that checks cholesterol, lipid and triglyceride levels).
• Colorectal cancer tests: Colorectal cancer kills 58,000 Americans each year, half of whom could be saved with routine screenings. Begin regular screening starting at age 50. Your doctor can help you decide which test is right for you. (Medicare covers four screening tests.)
• Diabetes test: Millions of people have diabetes and don't even know it. Every three years, have your blood glucose checked. If you're obese, have high blood pressure, high cholesterol or have a family history of diabetes, check it yearly. (Medicare covers diabetes screening for those at risk for the disease.)
• Mammograms: The risk of getting breast cancer increases with age. After age 40, annual mammograms are recommended for all women. (Annual mammograms are covered by Medicare.)
• Pap smear and pelvic exam: Pap smears are recommended every three years to detect cervical cancer. However, women who've had a total hysterectomy, or who are age 65 or older and have had three negative pap smears in a row, usually don't need to be tested. Pelvic exams are recommended annually. (Medicare covers both tests every 24 months, or once a year for high-risk women.)
• Prostate cancer screening: Tests such as a PSA (prostate-specific antigen) blood test or a digital rectal exam can help detect prostate cancer and should be part of an annual checkup starting at age 50. (Medicare covers these tests annually.)
• Osteoporosis test: All women at age 65 should get a bone density test to screen for osteoporosis. You may need screening earlier if you're at increased risk. (Medicare covers the bone density test once every two years.)
• Vaccinations: People over 65 should get a pneumococcal vaccine to protect against pneumonia. Anyone over 50 should get a yearly flu shot, and a tetanus booster is recommended every 10 years. (Medicare covers flu, pneumococcal and Hepatitis B shots.)
• Vision: Eye diseases, such as glaucoma, macular degeneration and cataracts, are common with age. Get your eyes checked every year or two after the age of 65. (Medicare pays for annual glaucoma screenings for high-risk beneficiaries. They also cover cataract surgery and one pair of eyeglasses after surgery, and some macular degeneration treatments.)
• Other screenings: It's also important to have your hearing tested by an audiologist every two or three years; have routine dental checkups at least once a year; and have annual skin examinations done by a dermatologist to check for skin cancers. (None of these are covered by Medicare.)
Savvy Note: As always, talk to your doctor about which tests are right for you, when you should have them, and how often.
Medicare Coverage
Out-of-pocket costs for Medicare's preventive services will vary. Some are completely free, while others will cost you 20 percent of the Medicare-approved amount. For more information visit www.medicare.gov/health/overview.asp, or call 800-633-4227 and ask for a free copy of the “Guide to Medicare's Preventive Services” (publication 10110).
Send your senior questions to Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit www.savvysenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” books.
