How Medicare Can Make Summer Healthier

Summer is a great time to focus on wellness and preventive care.

Here's how Medicare can help beneficiaries stay healthy during the hottest months of the year.

John, a 70-year-old Medicare beneficiary who loves gardening, spends several hours a day tending to his plants during the summer.

Recently, he has been feeling more fatigued and occasionally dizzy after being in the sun for too long.

John wonders how Medicare can help him stay healthy during the summer and what specific preventive services and wellness benefits are available to manage seasonal health challenges.

The Answer:

Understanding how Medicare supports summer wellness and preventive care can help beneficiaries like John safely enjoy the season.

Here's a detailed look at the preventive services and wellness benefits that Medicare offers, including some important caveats.

The Annual Wellness Visit

Medicare covers an annual wellness visit to develop or update a personalized disease prevention plan.

This visit includes a health risk assessment, an update of medical and family history, and various routine measurements.

However, it is important to note that the wellness visit is not a full physical exam and is specifically geared toward prevention and health planning.

Beneficiaries must ensure that their health care provider accepts Medicare to avoid out-of-pocket costs for this visit.

During John's annual wellness visit, his doctor advised John on the importance of hydration and scheduled a cardiovascular screening to ensure that his heart was handling the extra activity.

This preventive visit is crucial for staying on top of health issues that might worsen in the summer.

Preventive Services Covered by Medicare

Medicare also provides coverage for the following preventive measures:

Cardiovascular disease screenings: Medicare Part B covers cardiovascular disease screenings once every five years. While this is valuable for monitoring heart health, beneficiaries should be aware of the specific frequency limitations and ensure that these screenings are within the covered timeframe to avoid additional costs.

Diabetes screenings: Medicare covers up to two diabetes screenings per year for beneficiaries who are at risk for diabetes. This coverage is crucial for managing blood sugar levels, especially in hot weather. However, beneficiaries must meet certain risk factors, such as hypertension, obesity or a history of high blood sugar.

Vaccinations: Medicare covers a range of vaccinations, including flu, pneumococcal and hepatitis B vaccines, and COVID-19 vaccines.

Beneficiaries should confirm which vaccines are fully covered and under what circumstances, as some vaccines might require a copayment depending on the provider and location of service.

Managing Heat-Related Health Issues

Some clients with Medicare coverage may have special health concerns.

Diabetes or kidney disease: Medicare covers medical nutrition therapy for beneficiaries with diabetes or kidney disease, which includes counseling on diet and nutrition to manage these conditions.

It's important to note that the therapy is covered only for specific conditions and must be provided by a registered dietitian or nutrition professional who accepts Medicare.

Skin cancer screenings: While Medicare does not specifically cover routine skin cancer screenings, it does cover diagnostic services if there are concerns about skin cancer or other skin conditions.

Beneficiaries should be aware that routine screenings without symptoms or a physician's referral may not be covered and could result in out-of-pocket expenses.

John received nutrition counseling, which helped him adjust his diet to include more hydrating foods and avoid dehydration.

This service is covered by Medicare and is essential for maintaining health during hot weather.

Beneficiaries should verify that their nutrition professional is Medicare-approved to ensure coverage.

Navigating Coverage

It is essential for beneficiaries to communicate with their health care providers to understand what is covered and to plan their visits accordingly.

Beneficiaries should:

Verify the services they are eligible for under Medicare Part B.
Understand the distinction between what Medicare considers preventive care versus routine care.
Confirm with health care providers that they accept Medicare to avoid unexpected charges.
Keep track of the frequency limitations and specific conditions required for coverage to ensure that they receive the full benefits without incurring additional costs.

Through these Medicare-covered services and careful planning, John can enjoy his gardening safely and stay healthy throughout the summer.

By taking advantage of Medicare's preventive services and understanding the specific caveats and limitations, beneficiaries can better navigate their health care needs during the summer.

Medicare's comprehensive coverage ensures that beneficiaries can manage seasonal health challenges effectively and make the most of the warmer months.

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Bethany Cissell is director of business development and a Medicare expert at Allsup, a national disability representation provider based in Belleville, Illinois.