Vaccinations for seniors should be an essential priority. As we age, our immune systems weaken, making it crucial for seniors to remain updated with recommended vaccines, including boosters, to enhance protection. Diseases such as influenza (flu) and shingles are particularly serious and prevalent among older adults and are covered by vaccines.

Maintaining social connections with friends, colleagues, and family can serve as a significant reminder for seniors to stay current with their vaccinations.

However, a prevalent challenge is the misconception that vaccines are solely for children. In reality, seniors face an escalated risk of complications from diseases that are preventable by vaccination. There are now multiple diseases that seniors should receive vaccinations for, emphasizing the importance of dental insurance coverage for seniors‘ overall well-being.

Unlike children who have school vaccine requirements, seniors often lack similar incentives for vaccination. Furthermore, mobility issues can hinder seniors from accessing vaccination centers, necessitating efforts to arrange transportation or in-home vaccination services.

Overcoming vaccine hesitancy is critical, especially for seniors, who are at an increased risk of severe complications from preventable diseases. Medicare advantage plans often include coverage for vaccines and other healthcare services, ensuring that seniors can access the care they need.

Therefore, making vaccinations a priority for seniors is essential for safeguarding their health and well-being, and integrating them into existing Medicare advantage plans can enhance accessibility and coverage.

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MEDICARE ADVANTAGE AND VACCINES

Medicare Part D prescription drug coverage and Medicare Advantage prescription drug coverage covers most vaccines and immunizations. However, there are specific vaccinations that are always covered by Medicare Part B:

• Influenza (flu) shots: one flu shot every flu season.
• Pneumococcal (pneumonia) shots: If you have never received Medicare Part B coverage for a pneumonia shot; you get a first shot. After receiving the first shot you get a different second shot.
• Hepatitis B shots: Vaccination if you are medium or high risk.

LUNG CANCER SCREENINGS

Lung cancer is a cancer that attacks various tissues of the lungs. A frightening “more than 50% of patients with lung cancer are diagnosed after the age of 65, and 30% are older than age 70,” according to the National Institute of Health.com (2022).

Lung cancer screenings include a Low-Dose computed Tomography (LDCT, also called low-dose CT) chest scan.

Original Medicare Part B provides coverage for an annual lung cancer screening and LDT scan if all of the following apply:

• You are age 55-77
• You currently smoke or have quit smoking in the past 15 years
• You smoked or have smoked an average of one pack per day for at least 30 years
• You have no symptoms or signs of lung cancer
• And, you receive a Medicare-approved LDCT scan at a radiology facility

Before your first screening and LDCT scan, you have to see your primary

Before your first screening and LDCT scan, you must have a visit with

your PCP to discuss the benefits and risks of the scan. Your PCP will

also provide counseling on smoking risks and smoking cessation

services when appropriate.

MAMMOGRAM SCREENINGS

Mammograms can detect any abnormalities in breast tissue as well as breast cancer.

Original Medicare and Medicare Advantage, if you have no history of breast cancer or any symptoms. Part B covers:

• One baseline mammogram for women aged 35-39
• One annual screening mammogram for women age 40+

MEDICAL NUTRITION THERAPY

What is Medical Nutrition Therapy?

Medical nutrition therapy (MNT) is an essential component of diabetes management and education. According to the Centers for Disease Control and Prevention (CDC), “ MNT is defined as a “nutrition-based treatment provided by a registered dietitian nutritionist.” It includes “a nutrition diagnosis as well as therapeutic and counseling services to help manage diabetes.”

Medicare Part B covers MNT services upon getting a referral from your PCP, sCentersa licensed registered dietician, nutritionist, or other trusted nutrition specialist, and having one of the following conditions:

• High blood pressure.
• Heart disease.
• Diabetes
• Liver disease.
• Infertility
• Stroke
• Certain cancers.
• Mental health problems.

Diabetes

• Chronic renal disease
• Or, have had a kidney transplant in the past three years

PAP SMEARS, BREAST EXAMS, AND PELVIC EXAMS

Pap smears provide detection against early-stage vaginal cancer. They can also screen for fibroids, sexually transmitted infections (STDs), and other types of vaginal issues.

***Note: Breast examinations are included in the pelvic examination which also provides early detection for breast cancer.

Original Medicare Part B and Medicare Advantage covers a Pap smear, pelvic exam, and breast exam once every 2 years for all women. If your doctor feels you are at high risk, he may order you to have a breast examination once every 12 months,

PROSTATE CANCER SCREENINGS

Prostate cancer screenings provide early detection for prostate cancer. Medicare Part B  provides annual prostate cancer screening for all men aged 50 years and up. The prostate cancer screening includes a prostate-specific antigen (PSA) test and a digital rectal exam (DRE).

SEXUALLY TRANSMITTED INFECTION SCREENING AND COUNSELING

Sexually transmitted infections (STIs or STDs) are infections and diseases that are contracted through sexual activity, such as chlamydia, syphilis, gonorrhea, and or hepatitis B. Screening and therapy may help the patient, identify, manage, and treat STDs.

Seniors may underestimate their risk of contracting an STD and not take precautions such as using a condom and getting STD tested before having sex, as well as their partner getting tested before you have sex.

Original Medicare Part B and Medicare Advantage plans cover screening tests for syphilis, chlamydia, gonorrhea, and or hepatitis if your PCP primary care physician feels you are at a high risk or an increased risk of contracting an STD or you are pregnant.

STD screenings are covered by Medicare Part B or Medicare Advantage annually, once your PCP provides you with a referral. Medicare also provides coverage for in-person counseling sessions for adolescents or adults considered by their doctors to be at high risk. These therapy sessions may help reduce the risk of contracting an STD. Counselors can also provide patient education in a primary care setting on how to protect themselves and others from contracting an STD.

SMOKING CESSATION COUNSELING

Smoking cessation counseling and education can help you quit smoking. Original Medicare Part B covers two smoking cessation counseling attempts once per year. Each counseling session has the goal of having up to four face-to-face sessions with your healthcare provider, for a total of up to eight if the individual is compliant.

***Note: Over-the-counter smoking cessation drug treatments, like nicotine gum and patches; Medicare does not cover. Over the counter medications for quitting smoking are excluded by law from Medicare Part D prescription drug coverage. However, your Medicare Part D prescription drug coverage plan may provide coverage for certain prescription medications prescribed for smoking cessation.

Original Medicare covers smoking cessation programs if over-the-counter smoking cessation counseling at 100% of the Medicare-approved amount when your services are received from a participating provider. This means you pay zero deductible and zero coinsurance.

Medicare Advantage Plans are mandated to provide coverage for counseling without applying deductibles, coinsurance, or copayments when you see an in-network provider and meet Medicare’s eligibility requirements for the service.

MEDICARE ADVANTAGE AND ANNUAL WELLNESS VISITS

When you are new to Medicare you can choose to receive The Welcome to Medicare preventive visit. Medicare Advantage (Medicare Part C) also covers annual wellness visits. Some Medicare Advantage plans also offer more benefits, such as dental, hearing, and vision, that Original Medicare does not cover. If your primary care physician accepts assignments from Medicare, your Welcome to Medicare annual visit would typically cost you $0.

***Note: The Welcome to Medicare Preventive visit must be received by you within the first 12 months of your Medicare Part B enrollment.

If you have a Medicare Advantage plan, your copays and deductibles costs can vary if your visit or service is covered completely by Original Medicare Part B or Medicare Advantage plan.

As you continue to age, it’s very important to keep seeing your physician, because you may never have navigated the health challenges that come with aging. Annual Wellness Visits provide valuable ways for doctors to zero in on problems and address them before they get worse.

***Disclaimer: A Senior Healthcare medical specialist has reviewed this information. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns with your provider.

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