If you have Medicare or will soon have it, you probably know what it covers on a basic level. But do you know about the less common perks that come with Medicare coverage? These perks aren’t technically free, since Medicare itself isn’t free. However, many Medicare recipients don’t have to pay anything out of their own pocket for these benefits.
There are a few exceptions. For example, there may be limits on how often you can see a doctor, and your doctor must agree to Medicare’s billing rules. Still, it’s good to know that you can get these benefits if you have Original Medicare or Medicare Advantage.Medicare advantage plans come with their own set of benefits in addition to the services that Original Medicare requires. Below are the “free” services that Medicare beneficiaries can access. They all help you save money and stay in good health.
Part A Premiums
Part A mainly covers hospital stays and inpatient care. While Part B mainly covers services in outpatient centers and doctor’s offices. Most people don’t have to pay a monthly fee for Part A coverage as long as they or their spouse paid Medicare taxes when they worked. Usually, you need to work and pay Medicare taxes for at least 10 years to avoid paying a premium for Part A.
Welcome to Medicare Visit
After you sign up for Medicare Part B, which pays for doctor visits and other outpatient services, you can get one free “Welcome to Medicare” checkup at any time during the first 12 months. This checkup is not a full physical test, but it gives your doctor a chance to look at your health and make a plan for your future care. You don’t have to get the “Welcome to Medicare” checkup, but if you do, it will help your doctor create a baseline to keep track of your health with your future annual wellness visits. However, Medicare will not pay for a wellness visit in your first year of Part B.
Annual Wellness Visits
Medicare beneficiaries are also able to get a free wellness visit once a year. This visit is meant to help you update your personalized health plan depending on how your health has changed year to year. It helps your doctor find new symptoms or possible health concerns early. The visit includes:
- Reviewing your medical history as well as family medical history
- Updating or changing your prescriptions
- Recording your height, weight, and blood pressure
- Checking your cognitive impairment
- Creating a care plan based on any findings
It’s important to note that while the visit itself is free, if you get any additional testing or treatments that aren’t considered covered preventative care there may be a copay.
Medicare Part B covers a number of vaccines for free without any copayments. Starting in 2011 the Affordable Care Act got rid of cost sharing for many types of tests and vaccines that help people stay healthy. Here are the shots that Part B pays for. Depending on your age, risk, and when you get the vaccine or series of vaccines, you may have to meet certain requirements:
- COVID-19 – Even though the public health emergency stopped on May 11, 2023, Medicare still pays for COVID-19 vaccines. Providers who are part of Medicare can’t charge Medicare recipients for the shot.
- Flu – Most people of all ages get flu shots every year during flu season, which usually lasts from October to May, with most people getting sick from December to February. For extra protection, the Centers for Disease Control and Prevention (CDC) advises that people 65 and older get the high-dose version.
- Hepatitis B – Part B covers the hepatitis B vaccine as a preventive benefit for people with diabetes, end-stage kidney disease, or hemophilia, who are at medium or high risk for getting the virus.
- Pneumonia – Medicare pays for the pneumonia vaccine, which can help protect you from pneumococcal disease, which can lead to pneumonia, meningitis, and other illnesses. Medicare pays either a single dose of the vaccine or a two-dose series, with the second dose needed at least a year later for most people 65 and older. People who don’t have strong immune systems may get the second dose sooner.
Medicare pays for several cancer screenings. Although some have requirements or are only covered in certain time frames.
Medicare Part B covers one mammogram test every 12 months for all women 40 and over. If you are between 35 and 39 years old and are eligible for Medicare, you get one free baseline mammogram. If your doctor accepts Medicare assignment the mammograms are free. Accepting assignment means that your doctor agrees to accept the Medicare-approved amount for the test as full payment rather than charging more.
Medicare will cover several screenings for colorectal cancer with specific guidelines for each;
- Colonoscopy – If you have Medicare and are at high risk for colorectal cancer, you can get a screening colonoscopy every two years. If you don’t have a high chance of getting colon cancer, the test is covered once every 10 years, or 120 months. There is no minimum age, and if your doctor agrees, these tests won’t cost you anything.
- Fecal occult blood tests – If you are 50 or older and have Medicare, you may be able to get one fecal occult blood test every 12 months to check for colon cancer. If your doctor agrees to do the tests, you won’t have to pay for them.
- Stool DNA labs – Medicare will pay for a multi-target stool DNA lab test once every 3 years if you are 50 to 85 years old. You must meet certain requirements, such as having a normal chance of getting colorectal cancer and not having any signs of colorectal disease. If your doctor agrees to do the tests, you won’t have to pay for them.
Part B of Medicare pays for a Pap test and pelvic exam every 24 months if you have Medicare. As part of the pelvic exam, the breasts are looked at to see if there are any signs of breast cancer. You might be able to get a screening test once a year if:
- You have a high risk for vaginal or cervical cancer
- You’re at childbearing age and had an abnormal pap in the last 36 months
If you are between the ages of 30 and 65, your Pap test every 5 years also includes an HPV test. If your doctor agrees to do the tests, you won’t have to pay for them.
Medicare Part B pays for blood tests for prostate-specific antigen (PSA) and digital rectal exams (DRE) once a year for people 50 and older. The yearly PSA tests are free and won’t cost you anything if your doctor agrees to do them. The Part B deductible applies to the DRE, and Medicare will pay 80% of the allowed amount.
Medicare Part B will pay for a low-dose computed tomography (LDCT) lung cancer test once a year if you are between 55 and 77 years old. If your doctor accepts Medicare assignment, the tests will cost nothing. You do have to meet certain requirements such as:
- You have no lung cancer symptoms
- You smoke, or quit within the last 15 years
- Your smoking history had an average of a pack a day
Medicare Part B pays for a yearly screening for depression. To be screened for depression, you don’t have to show any signs or symptoms, but the screening has to happen in a place where people get basic care, like a doctor’s office. This means that Medicare won’t pay for your screening if it happens in a hospital, skilled nursing facility (SNF), or emergency room. The annual depression check is done with the help of a questionnaire that you or your doctor fills out. This quiz is meant to show if you are at risk for depression or have signs of it. If your test results show that you might be at risk for depression, your provider will do a full evaluation and, if necessary, refer you for more mental health care.
Most of the time, you should get a depression test when you already have an appointment with your doctor. But your provider can choose to do the screening on a different visit. Original Medicare pays 100% of the Medicare-approved amount for depression screenings when they are done by a qualified provider. This means you don’t have to pay anything (no deductible or share). Medicare Advantage Plans are required to cover depression screenings without deductibles, copayments, or coinsurance if you see a provider in their network and meet Medicare’s standards for the service.
When diabetes is treated early, it can help people avoid problems. Depending on how likely you are to get diabetes, Medicare will pay for up to two diabetes tests per year. Medicare will also help you learn how to take care of your diabetes, but you’ll have to pay for it. Medicare also has a program to help people who are at risk of getting diabetes, but haven’t been officially diagnosed. This program is free of charge.
Working With EZ
Using the free services Medicare gives is a good way to stay as healthy as possible. If you’re new to Medicare, you should learn how it works so you can take advantage of all the services it offers. EZ can help you sign up for Medicare, buy a Medicare Supplement Plan, or just figure out what your best choices are. Our insurance brokers work with the best firms in the country. You can get a free review of all the plans in your area from them. We’ll talk about your physical and financial needs and help you choose a plan that fits them. To get started, just call 877-670-3602 and talk to one of our certified agents.