Educating Clients on Preventive Care: What Retirees Need to Know About Medicare’s Services

In health care and finance, an ounce of prevention is worth a pound of cure.

Just as sound asset planning can mitigate financial mishaps, preventive medicine can keep minor health issues from becoming debilitating diseases. Given rising health care costs and growing uncertainty over preexisting conditions, proactive health management can protect a nest egg in retirement.

Fortunately for retirees, the ACA-expanded Medicare includes a wide array of preventive services. From mammograms and nutritional counseling to screenings for diabetes and cardiovascular disease, most senior health services are covered.

Still, too few retirees are aware of their options.

“In my experience, people going into Medicare for the first time have gaps in their literacy of how Medicare works that go well beyond these preventive screens,” says Tom West, SEIA partner. With three out of four Americans 65 and older living with multiple chronic conditions, few can afford to pass up the opportunity for low-cost preventive care.

While advisors won’t play a direct role in their clients’ health care, they are in a great position to educate and inform. Given the devastating effects of unexpected health care costs on a portfolio, it only makes sense to discuss preventive care options with your clients.

What’s covered

“Most preventive care services are available now, including mammograms, bone density testing, prostate screening and colorectal screening,” says Rhonda Underwood, independent broker and Medicare advisor.

Ninety-three percent of fee-for-service Medicare spending is used for people with multiple chronic conditions, and the CMS is taking a comprehensive approach to reducing those costs. For a complete list of services, clients can refer to the CMS’s official handout, “Your Guide to Medicare’s Preventive Services.”

Most of these services have qualifying risk factors, some of which require a prior diagnosis, at-risk assessment or specific family history. For a patient’s bone mass measurement to be covered, for instance, their doctors must have already indicated a risk of osteoporosis. Screenings for cardiovascular disease and depression, on the other hand, are available to everyone.

Also available to every first-time recipient is the “Welcome to Medicare” visit.

“You can get a no-cost appointment with your doctor during your first 12 months of Medicare, where you have a top-to-bottom screening of your medical history, prescriptions and health conditions,” says West. “It’s a way to start dealing with any chronic illnesses or health issues you may have and come up with proactive approaches to staying in good health.”

What’s not covered

Given the long list of preventive services Medicare includes, it might be easier to educate clients on what’s not covered. “Annual eye exams and hearing tests are the two things that stand out to me,” says Underwood. Part B doesn’t cover dentistry, either – one of the biggest out-of-pocket expenses among seniors.

Still, other Medicare products may cover clients’ dental, vision and hearing, depending on their enrollment choices.

“If Medicare covers a service, Medigap will pick up the balance – otherwise, it won’t pay at all,” says Underwood. “Medicare Advantage plans,” on the other hand, “offer everything traditional Medicare does, plus additional services.”