| COVERED
SERVICE |
ELIGIBLE
BENEFICIARIES |
WHAT
YOU PAY |
| Screening
Mammogram: Once per year |
All female
Medicare beneficiaries age 40 and older. |
20% of the
Medicare approved amount with no Part B deductible. |
| Pap Smear and
Pelvic Exam: (includes a
clinical breast exam) Once every three years. Once per year if you are at high risk
for cervical or vaginal cancer, or if you are of child bearing age and have had an
abnormal Pap Smear in the preceeding three years. |
All
female Medicare beneficiaries. |
No coinsurance and
no Part B deductible for the Pap Smear. For all other exams, 20% of the Medicare approved amount with no
Part B deductible. |
| Colorectal Cancer
Screening: -- Fecal Occult
Blood Test
once every year
-- Flexible Sigmoidoscopy
once every four years
-- Colonoscopy
once every two years for high risk
-- Barium Enema
Doctor can substitute for sigmoidoscopy
or colonoscopy |
All Medicare
beneficiaries age 50 and older, however, there is no age limit for having a colonoscopy. |
No coinsurance and
no Part B deductible for the fecal occult blood test.
For all other tests, 20% of
the Medicare approved amount after the annual Part B deductible. |
| Diabetes
Monitoring: Includes
coverage for glucose monitors, test strips and lancets without regard to the use of
insulin. |
All Medicare
beneficiaries with diabetes. |
20% of the
Medicare approved amount after the annual Part B deductible. |
| Bone Mass
Measurements: Varies
with health status of beneficiary |
Medicare
beneficiaries at risk for losing bone mass. |
20% of the
Medicare approved amount after the annual Part B deductible. |
| Flu Shot Once per year
Pneumococcal Vaccination
One may be all you ever need - ask your
doctor
Hepatitis B Vaccination
If you are at high or intermediate risk
for hepatitis. |
All Medicare
beneficiaries. |
No coinsurance and
no Part B deductible for flu or pneumococcal vaccinations if doctor accepts assignment.
Hepatitis B vaccination, 20% of the Medicare approved amount after the Part B deductible. |
