HealthQuest

Preventive care can extend lives and promote one’s general health and well-being. Even though Medicare covers a number of preventive services, not all beneficiaries avail themselves to those options. The reason for this is still unclear. Are seniors unaware that Medicare does pay for numerous preventive – and often lifesaving services? Or, do seniors merely choose not to exercise some of these preventive benefits to which they are entitled?

A recent government report says most Medicare beneficiaries receive some, but not all of their recommended preventive services. Analysis of data from the year 2000 showed that nine out of ten Medicare beneficiaries visited a physician at least once that year. On the average, beneficiaries made six visits or more to their doctors’ offices within the 12-month period. Even though many seniors visited their physicians, they did not always receive recommended preventive services, such as flu or pneumonia vaccinations. The number of preventive services such as cancer screenings, colonoscopies and bone mass measurements for women were also lagging among services rendered to those who were eligible.

Of the survey participants who did have a physical examination, and were found to have high blood pressure, about 30 percent of them were unaware of their potentially dangerous medical condition. Additionally, another study revealed that nationally, an estimated 2.1 million seniors may have high cholesterol and also remain uninformed about the serious circumstance.

Many Medicare beneficiaries do not know they are at risk for detrimental health conditions that preventive care could detect. And, as has often been noted in conditions such as breast and prostate cancers, the survivors are most often those who were diagnosed in the early stages of their disease.

Although a preventive care examination may offer an opportunity to deliver some preventive services, that, in itself, is not enough to ensure better health among seniors. Because of the number of people not receiving preventive care for which they are entitled, the Medicare Senior Risk Reduction Program is now underway. The program’s purpose is to identify health risks and follow up with preventive services that can be provided by means in addition to examinations by physicians.

The Government Accountability Office, which conducted the Medicare Prevention Care Benefits study, does state that for some beneficiaries, certain services may not be warranted, or may be of limited value. Appropriate preventive care also takes into account an individual’s age, family history and particular health risks. It is not prudent, medically and financially, to simply rely on a standard battery of tests to serve millions of seniors with varying needs.

Since the 1990s, the U.S. Preventive Services Task Force has added nine diagnostic and/or preventive medical services to help seniors remain healthy. Among these additions are flu immunizations, several types of cancer screenings for both males and females, and glaucoma tests.

Included in the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, is a one-time preventive care examination for new enrollees. This benefit is available to seniors in 2005.

How should seniors find out which preventive services they need, or even those services for which they are eligible? Ask your physician. Doctors can best direct patients to services that benefit individuals the most. In addition to knowing which prescriptions are covered by Medicare, your health care professional can also find out whether the preventive services you may need – will be covered.

Prevention is indeed the best medicine to guard against long-term illness and disease. Ben Franklin was right: An ounce of prevention is worth a pound of cure.

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