What Preventative Care Services Are Covered by Medicare?

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We're often asked why preventative care is so essential to our everyday lifestyles. The most important part of preventative health care is that it alleviates the risk of chronic illnesses going unnoticed. According to the U.S. Centers for Disease Control and Prevention: "Chronic diseases, such as heart disease, cancer, and diabetes, are responsible for 7 of every 10 deaths among Americans each year and account for 75% of the nation’s health spending. These chronic diseases can be largely preventable through close partnership with your healthcare team, or can be detected through appropriate screenings, when treatment works best."

Fortunately, patients under the Affordable Care Act or Medicare have access to free preventative care to help combat their risks for chronic illnesses. Unlike other services, preventative care is covered by your patient's network provider through the money collected by his or her monthly premium, which means it doesn't require a copay, coinsurance or deductible unlike other services.

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What preventative care services are included?

For adults there are 18 general services that are delivered by a health network provider. For women specifically, there are 22 and for children there are 26. Here's a condensed list of what your patient's network provider may provide. (For a full-list of services and limitations, visit HealthCare.gov.)

  1. Abdominal aortic aneurysm one-time screening
  2. Blood pressure screening
  3. Cholesterol screening
  4. Depression screening
  5. Diabetes (Type 2) screening
  6. Hepatitis B and C screening
  7. HIV screening
  8. Obesity screening and counseling
  9. Tobacco use screening
  10. Lung cancer screening
  11. Vision screening
  12. Autism screening

As we stated above, please note the limitations—including gender, age, etc.—before you schedule an appointment. We also highly recommend that your patient guarantees the service's coverage under his or her network provider. This way, your patient won't run the risk of being billed for a service that he or she ultimately can't afford. For your patient to take full advantage of preventative care, he or she should consider maintaining good health habits outside of the doctor's office. This may include regular physical activity, weight control, moderation of alcohol and proper nutrition.

To learn more about preventative care measures, check out our blog for similar topics of interest.

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