Medicare Wellness & Preventive Care Recommendations

Your overall wellness is important to us. Turning 65? The Medicare Wellness Visit is intended to give you and your care team time to talk about how you’re doing, find ways you can avoid illness and help you to stay feeling your best.

Your Medicare Wellness Visit

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Turning 65? It is time for your free Medicare Wellness visit!

The Medicare Wellness Visit is intended to give you and your care team time to talk about how you’re doing, find ways you can avoid illness and help you to stay feeling your best.

Our Annual Wellness Team of registered nurses is reaching out to existing patients who are signed up for Medicare Part B coverage to schedule their first free Medicare Wellness visit.

  • While Medicare Part A coverage is automatic through the federal government, Medicare Part B coverage is optional and includes a premium. Medicare Part B coverage waives copays and deductibles for annual wellness visits.

Your Medicare Wellness Visit will last approximately 45 to 60 minutes. Please understand your visit may not include a ‘head-to-toe’ physical exam. If you need to be treated for current or new health problems, please call your primary care provider so we can schedule a separate appointment for you.

What should you bring to your appointment?

  • Your insurance card(s)
  • Completed forms in the packet you received in the mail
  • A bag with all your medications, including over-the-counter medications, vitamins and herbals
  • Copies of advanced directives

At your visit, you will develop a partnership with the nurse and share life-long goals that you will discuss yearly, so you can stay healthy and independent for as long as possible!

Please contact your health care provider if you have questions or think you will need our help completing the paper forms enclosed in the packet mailed to you.

What is the difference between a screening test and a diagnostic test?

A screening test checks for disease in a person who feels well. This means they do not show any symptoms, but we check them to try to catch a disease early. Screening tests are decided by risk factors (things like age, gender, family history, etc.).

Diagnostic testing is for when someone shows signs of a disease.

An example is colon cancer screening. A person who is average risk for colon cancer (meaning they don’t have any family history of colon cancer, or diseases that increase risk of colon cancer like Ulcerative Colitis), should have their first screening test at age 45.

If a person has signs of colon cancer, like blood in their stool and weight loss, they should have a diagnostic test. The tests may be the same type of test or a different test (testing the stool for blood you can’t see, or a colonoscopy), and they would have the test done sooner than a screening test. Insurance coverage is also different for screening and diagnostic tests.

Screening recommendations can be confusing as different medical societies may publish different guidelines. This is because the benefits and risks are compared for each screening test, and different organizations might place different value on each part.

Recommendations are evaluated constantly and there are often updates. Current screening guidelines can be found at USPSTF:

https://www.uspreventiveservicestaskforce.org/uspstf/recommendation-topics/uspstf-a-and-b-recommendations

Additionally, vaccination guidelines can be found at the CDC:

https://www.cdc.gov/vaccines/schedules/index.html

Evaluating your risk factors for different diseases, discussing the risks and benefits of screening, and checking for signs and symptoms of different diseases is very complex and why it’s so important to have an annual wellness visit with your primary care provider every year. Contact Mason Health to schedule your Annual Wellness Visit.

Screening Recommendation List:

Cancer screening is a high priority at Mason Health. We are placing special focus on promoting breast, colon, and cervical cancer screening in 2024-2025.

The recommendations below are for general risk. If you have a family history of certain cancers, personal history of cancer or certain diseases, your recommendations may be different.

Recommendations:

  • Breast cancer screening with mammogram: Every 1-2 years for average risk women age 40-74 years. More information about breast cancer screening is available here.
  • Colon cancer screening: Strongly recommended for age 45-49 years and 50-75 years with one of the following tests for people at average risk of colon cancer:
      • Stool testing every 1-3 years, depending on the type of test.
      • CT colonography every 5 years
      • Flexible sigmoidoscopy every 5 years
      • Flexible sigmoidoscopy every 10 years plus FIT every year
      • Colonoscopy every 10 year
      • Detailed risks and benefits of different colon cancer screening tests is available here.
    • For age 76-85 years, there may be a small benefit and whether or not to screen should be discussed with your PCP, considering overall health, prior screening history, and preferences.
  • Cervical cancer screening depends on age and the type of test done:
    • Women aged 21-29 years: every 3 years with cervical cytology alone
    • 30 to 65 years:
      • every 3 years with cervical cytology alone or
      • every 5 years with high-risk human papillomavirus (hrHPV) testing alone,
      • or every 5 years with hrHPV testing in combination with cytology (cotesting).

It’s important to have prior pap records or provide your prior provider’s contact information to your PCP to check the type of prior test and results. Many people think they have had a pap done, when a pelvic exam was done without a pap, or the result was abnormal and a sooner pap is needed.

  • Lung cancer screening:
      • Adults aged 50-80 years who are current smokers or quit within the past 15 years and
      • have smoked the equivalent of an average of 1 pack per day for 20 years (1/2 pack per day x 40 years, etc)

Screening should be discontinued once a person has not smoked for 15 years or develops a health problem that substantially limits life expectancy or the ability or willingness to continue screening.

Free tests or screenings as part of the Medicare Annual Wellness Visit

  • Abdominal aortic aneurysm screening, one time
  • Alcohol misuse screening and counseling, yearly
  • DEXA scan, a bone mass measurement, or bone density test, every two years.
  • Cardiovascular disease screening, every five years, plus one behavior therapy visit per year
  • Depression screening, yearly
  • Diabetes screening, up to twice per year, for people at high risk of diabetes
  • Flu shots
  • Hepatitis B shots, if you are at medium or high risk
  • Hepatitis C screening test, for those at high risk whose doctor orders the test
  • HIV screening, every 12 months for people over 65 who are high risk
  • Colorectal cancer screening (fecal occult blood test, colonoscopy, flexible sigmoidoscopy and/or barium enema).*
    • *20 percent coinsurance under Medicare Part B may apply if polyps are found and removed during the screening, and also if you have a barium enema as part of the colorectal cancer screening
  • Lung cancer screening for current and former smokers who quit within the past 15 years
  • Screening mammogram each year (if there are any abnormal findings, or a prior result was abnormal, a diagnostic mammogram may be needed and do include cost-sharing)
  • Nutrition therapy services for people who have diabetes, kidney disease, or who have had a recent kidney transplant
  • Obesity screening and counseling, for people with a BMI of 30 or more
  • Pap test and pelvic exam (including clinical breast exam) every two years, or more often if at high risk
  • Pneumococcal shot
  • PSA screening for prostate cancer (no charge for an annual PSA test, but the Medicare Part B deductible and coinsurance apply to a digital rectal exam)
  • Sexually transmitted infection screening and counseling. This includes screening tests for Chlamydia, Syphilis, Gonorrhea, and Hepatitis B
  • Smoking cessation counseling

Medicare screening test coverage information can be found at: https://www.medicare.gov/coverage/preventive-screening-services.

Additional Wellness Resources at Mason Health:

Mental Health and Wellness:

Patients can connect with our behavioral health providers through a referral from their primary care provider. Our behavioral health providers offer the following services:

  • Patient and family education
  • Goal planning
  • Medication management and education
  • Assistance with connecting to community services

Learn more at Behavioral Health & COVID-19 Wellness or ask your primary care provider for a referral.

Care Management:

Our care managers work with patient to provide education and management for chronic diseases. They also help patients identify and overcome barriers to fulfilling their care needs, and support you in becoming an active participant in your own health care. Contact your primary care provider for a referral.

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Care Managers Sarah Fulkerson and Stacy Bonin, RN with a patient

Cancer Navigation:

Our patient navigator will work with you and your family to maximize your health experience. Learn more at Cancer Navigation.

Diabetes Wellness Services:

Our Diabetes Prevention Program includes individual or small group instruction, as well as monthly support groups and other educational programs. For more information, call the Diabetes Wellness Center at 360-427-7332.

Community Health Worker:

Mason Health has a Community Health Worker dedicated to connecting patients with health care and social services. They can also help patients prioritize their goals. Call 360-968-9026 or (360) 432-3296 for more information.

Peer Navigator:

Our Peer Navigator can work with you on substance or alcohol misuse issues. Call 360-485-2513 for more information.

Have You Had Your Flu Shot This Year?

Learn More About Medicare Wellness