They say there’s no such thing as a free lunch but there are a lot of free Medicare benefits available!
Ok, they aren’t exactly “free.” Somebody pays for them. But they’re free to you! You can access these benefits with no copay, coinsurance, or deductible.
These benefits are free to you because early detection and preventive care save Medicare money in the long run and can save lives. The government knows how important it is for you to get screened for common illnesses, so they removed cost barriers for these essential services. These benefits allow you to stay healthy, detect potential health issues early, and avoid more invasive and costly treatments down the road.
From vaccinations to cancer screenings, these “free” services are essential tools in managing your health, and they can significantly reduce future medical expenses, both for you and for Medicare. Whether you’re new to Medicare or have been enrolled for years, it’s important to stay informed about these benefits and make the most of what’s available.
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Welcome to Medicare and Annual Wellness Visits
Your journey with Medicare begins with a free “Welcome to Medicare” preventive visit.
This one-time visit must be scheduled within the first 12 months of enrolling in Medicare Part B. It serves as a comprehensive health assessment and a chance to develop a personalized prevention plan.
Following this initial visit, you’re entitled to a free Annual Wellness Visit every year. This is not a full physical exam but rather an opportunity to update your personal prevention plan and check for any cognitive issues.
These wellness visits are crucial for maintaining good health and catching potential problems early.
Screenings and Tests
Medicare covers a wide array of screenings and tests at no cost to you. These include:
- Cardiovascular Screenings: These include tests for cholesterol, lipids, and triglycerides.
- Diabetes Screenings: You can get up to two diabetes screenings per year if you’re at risk.
- Cancer Screenings:
- Mammograms for breast cancer screening
- Colorectal cancer screenings, including colonoscopies
- Lung cancer screenings for eligible former smokers
- Prostate cancer screenings
- Cervical and vaginal cancer screenings
- Other Important Screenings:
- Bone mass measurements
- Glaucoma tests
- Hepatitis B and C screenings
- HIV screenings
- Abdominal aortic aneurysm screenings
While these screenings are free, any follow-up diagnostic tests or treatments may incur costs. For instance, if a mammogram leads to further testing, you may be responsible for 20% of the cost under Medicare.
Note: Even with Medicare, you could still face significant out of pocket costs when you need care.
Without additional protection in place, that 20% Part B coinsurance is theoretically unlimited. And you still face thousands of dollars in Part A deductibles, as well: Up to $1,632 per hospital stay, plus copays of up to $408 to $816 per day as of 2024.
Furthermore, Original Medicare by itself doesn’t include prescription drug coverage.
Most people need additional protection against high medical costs. So it’s a good idea to consider some private sector solutions to help shield you from potentially devastating medical bills in retirement.
You have three great options, each with their potential advantages and disadvantages:
- Medicare supplement insurance (Medigap)
- Medicare Advantage
- Medi-Share 65+, a non-insurance health sharing alternative to traditional insurance approaches.
Learn more about your private options in addition to Medicare.
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Vaccinations
Staying current on vaccinations may be a key component that your doctor recommends for maintaining your overall health, especially as you age.
Fortunately, Medicare provides comprehensive coverage for a variety of essential vaccinations at no cost to you, ensuring you can stay protected without worrying about out-of-pocket expenses.
Here are some of the critical vaccines Medicare covers:
- Flu Shots: The flu can lead to severe complications, particularly in older adults. Medicare covers your annual flu shot, helping you avoid the illness and reduce the risk of hospitalization.
- COVID-19 Vaccines: Medicare fully covers the cost of COVID-19 vaccinations and boosters.
- Pneumococcal Shots: Pneumonia is a serious condition that can be life-threatening for seniors. Medicare covers pneumococcal vaccines, which protect against infections like pneumonia, meningitis, and other bloodstream infections.
- Hepatitis B Shots: Hepatitis B can cause liver complications, including cancer. Medicare covers the Hepatitis B vaccine if you’re at medium or high risk, ensuring that you have the necessary protection.
Counseling and Therapy Services
Medicare also offers free counseling services to help you maintain a healthy lifestyle:
- Smoking Cessation: If you use tobacco, Medicare covers up to 8 face-to-face counseling sessions in a 12-month period to help you quit.
- Alcohol Counseling: You can receive up to 4 brief face-to-face counseling sessions per year if you’re found to be misusing alcohol but aren’t alcohol-dependent.
- Obesity Behavioral Therapy: If you have a body mass index (BMI) of 30 or more, you’re eligible for weight loss counseling.
- Nutrition Therapy: Medical nutrition therapy services are available for those with diabetes or kidney disease, or who have had a kidney transplant in the last 36 months.
Diabetes Management
- Diabetes Self-Management Training (DSMT)
With DSMT, Medicare covers training that teaches you how to manage your blood sugar, use insulin, understand your medications, and plan your meals.
This program helps you take control of your diabetes and live a healthier life. You’ll need a referral from your healthcare provider to participate.
- Medicare Diabetes Prevention Program (MDPP)
If you’re at risk for Type 2 diabetes, the MDPP offers free lifestyle coaching to help you lose weight, increase physical activity, and improve your diet. This program is proven to reduce your risk of developing diabetes through simple, sustainable changes.
These programs are designed to improve your health and help you avoid costly complications. Talk to your doctor to find out if you qualify.
Make the Most of Your Medicare Benefits
To ensure you’re maximizing your Medicare benefits, consider these tips:
- Be proactive about scheduling your annual wellness visit to stay on top of your health.
- Discuss your health history with your doctor to determine which free screenings are appropriate for you based on your risk factors.
- Take advantage of the Fall Open Enrollment period (October 15 – December 7) to review and adjust your Medicare coverage for the following year.
Need help going over your options? Make an appointment with a MediGap Advisors expert Personal Benefits Advisor. - Consider supplemental coverage options like Medigap or Medicare Advantage plans to help with out-of-pocket costs for services not covered by Original Medicare.
- Stay informed about changes to Medicare coverage, as benefits can vary from year to year.
- Utilize the General Enrollment Period (January 1 – March 31) if you missed your Initial Enrollment Period and don’t qualify for a Special Enrollment Period. During this time, you can sign up for Medicare Parts A and/or B, with coverage starting the month after you enroll.
By following these steps, you can ensure you’re making the most of the free services and enrollment opportunities Medicare offers.
The Value of Prevention
These free services are not just beneficial for your health; they’re also cost-effective for the Medicare system.
By detecting health issues early or preventing them altogether, these services can help avoid more expensive treatments down the line.
For example, regular colorectal cancer screenings can detect precancerous polyps, which can be removed before they develop into cancer. This not only saves lives but also reduces the need for costly cancer treatments.
Similarly, diabetes screenings and management programs can help prevent or delay the onset of diabetes-related complications, which can be extremely costly to treat.
A Closer Look at Health Sharing Plans
Medi-Share 65+ is a health-sharing plan designed to complement Original Medicare by helping cover out-of-pocket expenses like deductibles, copays, and coinsurance.
Unlike traditional insurance, Medi-Share 65+ allows members to share these costs among a community of participants, offering a unique approach to managing healthcare expenses.
Key Features of Medi-Share 65+:
- Annual Household Portion (AHP): Members pay the first $500 of Medicare-approved expenses under Parts A and B each year.
- 100% Cost Sharing: After meeting the AHP, 100% of your additional out-of-pocket costs, including Part A and B deductibles, 20% coinsurance, and “excess charges” above Medicare’s approved amount, are shared among plan members. You pay nothing more out of pocket for most medical needs that are covered under Medicare Parts A or B.
- Affordable Contributions: Monthly contributions are $99 for individuals aged 65-75, and $150 for those aged 76 and older.
- Pre-Existing Condition Waiting Periods are Waived During Initial Enrollment: If you enroll during your initial Medicare open enrollment period, there are no restrictions for pre-existing conditions.
- Price Lock-in: Members under the age of 75 receive a price lock-in until they turn 75. That’s up to ten years of price-lock-in benefits if you sign up at age 65!
While Medicare provides significant coverage, health sharing plans like Medi-Share 65+ can help manage the costs Medicare doesn’t cover, particularly in high-cost areas where Medigap premiums can be expensive. However, it’s essential to understand that health sharing plans are **not insurance** and may have certain limitations, such as waiting periods for pre-existing conditions.
Medi-Share 65+ is particularly appealing to individuals in good health without major pre-existing conditions. Those interested should consider joining before needing significant medical services to avoid potential waiting periods. Additionally, as with most Medigap plans, Medi-Share 65+ does not include prescription drug coverage, so many participants opt to enroll in a Medicare Part D plan for prescription costs.
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Take Advantage of Free Medicare Benefits
The free preventive services offered by Medicare are a valuable resource for maintaining your health and catching potential issues early.
By taking advantage of these benefits, you’re not only saving money but also investing in your long-term health and well-being. Remember, these services are only beneficial if you use them. Schedule your annual wellness visit, stay up-to-date on your vaccinations, and discuss with your doctor which screenings are right for you. Your future self will thank you for the proactive steps you’re taking today to safeguard your health.
Simplify the Process with a Personal Benefits Manager
Getting personalized assistance is easy and free! Simply schedule an appointment with our dedicated Personal Benefits Managers, and we’ll guide you through the entire process:
- We’ll carefully assess your unique needs and situation
- Provide expert analysis to help you understand your options
- Equip you with all the key information you require
- Enable you to make a confident, well-informed decision
Your Personal Benefits Manager is there to streamline the process, offer customized support, and ensure you get the best possible outcome. Book your appointment today to get started!
For Further Reading:
Tom Lockwood is a Personal Benefits Manager at MediGap Advisors. Tom has a passion for bringing clarity to those confused about Medicare. He is an authority on Medicare, Medicare supplement plans, Medicare Advantage plans, and Part D prescription drug plans. Read more about Tom on his Bio page.