What women should know about Medicare coverage for physicals and exams

As women age, their risk of certain chronic diseases increases. We can thank the aging process and the loss of the protective effects of estrogen after menopause. Older women are more susceptible to diseases such as osteoporosis, which can cause brittle bones. The risk of heart disease increases as does the risk of dementia, partly because women tend to live longer than men and the risk increases with age.

Diagnosis of some conditions is more difficult because of the frequency, presentation and long-term effects of many diseases appear differently in women more than in men. That’s a major reason not to skip regular checkups and wellness visits, as staying healthier through preventative care and screening can ease the health challenges of old age. becomes easier.

Physical examinations are important for older women

Medicare pay for Annual preventive care with no copay. That’s especially true for women, who make up more than half (55%) of all Medicare beneficiaries in 2021. Nearly 1 in 8 (12%) are 85 or older; many people have functional difficulties, an analysis from KFF found. That includes difficulty walking, bathing, vision loss or other problems that significantly affect their quality of life. People 85 and older tend to have five or more chronic diseases, treatment of which becomes more complex with age.

Women know they should focus on their health, said Alina Salganicoff, director of women’s health policy at KFF. However, “sometimes the system is not set up for women to take care of themselves because they have competing needs, like work or family care responsibilities.” This often creates limited time for women to prioritize themselves.

And if women don’t have access to a primary care provider or don’t get regular care, they may miss out on important precautions like mammogramshe speaks.

“Having insurance is the first step, but many other factors influence whether women get the services they need,” Salganicoff says. That includes their relationship with their clinician, their previous experiences, access to care, fears about conditions like dementia or cancer, or supports social problems such as traffic, mobility or cognitive problems or having someone with you.

That first health visit is probably the key to everything else in managing an older patient, according to Segen Chase, an internist in private practice in Manhattan, Kansas. About 35% of the patients at her clinic are Medicare beneficiaries, many of whom live in nearby retirement communities.

“It’s important that we do whatever we can to have them visit and work with the facility’s wellness coordinator,” said Chase, a member of the American Medical Women’s Association. to carry out all necessary assessments”. WEL leadership training program.

Physical examinations include annual monitoring of many behavioral and physical signs such as vision, hearingfall risk, sexual health, nutrition, wine and tobacco use, as well as psychosocial risks such as depression, stress, loneliness or social isolation, pain and fatigue. Patients also experience it cognitive screeningcan reveal subtle changes in brain health.

A health check can also include questions about someone’s living situation, Chase said, because it helps us determine if they need extra help at home. “It also gives us the opportunity to discuss care planning in advance when they are not in a crisis situation.” Medicare pays this cost as part of the Part B annual health check-up.

According to KFF’s analysis, women on Medicare generally have higher rates of certain health conditions than men. Urinary incontinence (37% vs. 18%), depression (31% vs. 21%), osteoporosis (29% vs. 7%), and lung disease (20% vs. 16%) were more common in women than men. Women are also more likely to live alone than men. More than one-third of all women with Medicare (36%) live alone, and more than half of those 85 and older live alone. This can increase the risk of loneliness and social isolation, to be connected to according to the American Medical Association, increases the risk of depression, dementia and stroke.

A physical exam can help uncover some underlying problems, says Chase, and together, the doctor and patient can create a care plan to manage these problems and chronic conditions. other.

What preventive health services does Medicare cover for women?

Medicare Part B include a variety of preventive services Benefits to women’s health, including:

There are no copays, deductibles or coinsurance fees for these and other covered screenings, although certain other criteria may apply, as specified. Medicare Rights Center. Medicare Part A (hospital insurance) and Medicare Part B (health insurance) will even help pay for an osteoporosis injection and a visit from a home health nurse to give the injection if you eligibility.

According to Salganicoff, this partial list of screenings covered by Medicare can seem daunting, which is why it’s important for women to talk to a clinician and discuss their health history, risk factors, and health concerns. and their priorities. “This is a complex program and can be difficult for people to use,” she said.

Chase says these aren’t one-time conversations either. As we age, priorities and the realistic goals a person needs to achieve may change. Therefore, constant dialogue is the key to maintaining health.

We know certain conditions present differently in women, so “a lot of the medicine is about communication, preserving the sanctity of the relationship while honoring their independence and finding figure out what is most important to that person,” she said. Chase finds these discussions help women open up about their physical and mental challenges, especially caregivers. “They’re often exhausted but don’t want to admit it.”

Provide women with clear, simple information so they can learn about all of their Medicare benefits and get the support they need to get the preventative care and services they need other, can be of great help in keeping women healthy in old age.

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