Monthly Column - December, 2004

WHAT MEDICARE BENEFICIARIES CAN EXPECT IN 2005

Along with the New Year will come implementation of several provisions passed as part of the Medicare Act of 2003. Among the provisions scheduled to become effective beginning January 1, 2005, are a few new additions to the list of preventive benefits that will be covered by Medicare.

Currently, Medicare provides coverage for preventive services such as screening mammography, pap smears, bone density tests, colorectal screenings, prostate screenings, glaucoma screenings and flu vaccinations.

On January 1, 2005 Medicare will also provide coverage for cardiovascular screenings for early detection of cardiovascular disease every two years. The cardiovascular screenings, performed through blood tests, will include tests for cholesterol levels, lipid levels and triglyceride levels. In addition, a diabetes screening test, consisting of tests for fasting blood glucose levels, will also be available for individuals at “high risk” for developing diabetes. Persons defined by the law as being “high risk” are those with any combination of the following health conditions; hypertension, dyslipidemia (elevated lipids in the blood), obesity, a previous history of an elevated fasting blood glucose level or previously identified impaired glucose intolerance. For such individuals, coverage will be provided for fasting glucose tests done no more than every six months.

For new beneficiaries who become eligible for Medicare after January 1, 2005, coverage for one “Welcome to Medicare” physical will be available if performed within the first six months after they initially become eligible for Medicare Part B. Coverage of this one-time physical exam however, does not include laboratory testing.

In addition to the new preventive benefits, beneficiaries will to begin to hear more about the Medicare Prescription Drug benefit, or “Medicare Part D,” which is slated to begin January 1, 2006. Initial enrollment in the Part D program will begin November 15, 2005. Information about the prescription drug plans to be offered in the area will become available during 2006. Medicare beneficiaries should try to seek information about the new Medicare Drug program in order to ensure that they make informed decisions regarding to their enrollment in a Part D plan. Information, as it becomes available, can be obtained by calling the Center for Medicare Advocacy at 860-456-7790 or the CHOICES Program at 1-800-994-9422.

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The Center for Medicare Advocacy, Inc. is a national, non-partisan education and advocacy organization that promotes fair access to Medicare and health care. The Center’s national office is in Mansfield with offices in Washington DC and throughout the country. For more information contact Attorney Lara Stauning at (860)456-7790 or visit the Center’s website: www.medicareadvocacy.org. Se habla espanol.