Categorized | Opinion

Medicare and prevention: Take charge of your health

By Ron Pollack

Experts tell us the key to making New Year’s resolutions is to make your goals realistic. So if walking a mile is a challenge, don’t tell yourself this is the year you’re going to run a marathon. Instead, how about something more attainable — something that will serve you better in the long run? Let this be the year you take charge of your health. Thanks to the new health care law, Medicare can now help you do just that.

As of Jan. 1 most preventive care covered by Medicare is now free; no deductibles, no coinsurance. And Medicare is now covering a free annual physical exam, or what they’re calling a “wellness visit.” These changes are good news for your wallet — and for your health. Here’s why:

Medicare has always done a pretty good job of covering you when you get sick. But it has not focused as much on keeping you well. That’s because Medicare covered doctors’ visits when you got sick, but oddly did not pay for your doctor to take the time to assess your health and talk with you about staying healthy. That approach is finally changing.

If you have traditional Medicare, you’re now entitled to a free annual wellness visit (if you have a Medicare Advantage plan, your coverage is similar, but check with your plan for details). You can meet with your primary care doctor and go over your personal and family history. You should share with your doctor a list of all the other health professionals you see and all the prescriptions you take. Your doctor should take your height, weight, blood pressure, other vital statistics, and check to see if you’re up-to-date with preventive screenings and services like vaccines and cancer screenings. Make sure you take time to share what’s on your mind and develop a plan with your doctor for preventing disease and improving your health.

What’s more, under the new law, you do not have to pay out-of-pocket for most of the preventive services and screenings your doctor recommends. Some of these can literally save your life: Did you know that over 40 percent of seniors do not get their recommended pneumococcal vaccine — a vaccine that prevents pneumonia, which kills about 40,000 Americans each year? Other services have long-term benefits. Getting a mammogram or colorectal cancer screening is nobody’s idea of a good time, but it’s a small price to pay for finding cancer early when it can be treated more successfully. And with the new health care law, the price you pay for these tests and services is literally zero.

Of course, if you do get sick, Medicare will cover your doctors’ and hospital bills the same as it always has. Make sure you understand what’s covered and what’s not, and how Medicare works with any secondary coverage you have, like a medigap policy, coverage from your former employer, or Medicaid. If you have questions, call Medicare at 800-MEDICARE. You can ask for the name and number of your local State Health Insurance Counseling and Assistance Program (SHIP), which offers free insurance counseling to everyone with Medicare.

Medicare’s improved preventive benefits under the new law might seem like a small thing. But if seniors take full advantage of them, they can mean the difference between sickness and health, and in some cases between life and death. And who knows? With the right advice from your doctor, by 2012, maybe you will be able to walk that mile — or even run that marathon.

Ron Pollack is the executive director of Families USA, a national organization for health care consumers. It is nonprofit and nonpartisan, and its mission is to secure high-quality, affordable health coverage and care for all Americans. Online:

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