Preventive health services include screening for health problems that are not yet symptomatic, checking for common but often overlooked health problems, and vaccines or medications that may reduce the risk of future illness.1
Since 2011, in response to the provisions of 2010’s Affordable Care Act, Medicare has offered a variety of preventive health services for free when ordered during the Medicare Part B Annual Wellness Visit.2
Preventive care for seniors
The U.S. Preventive Services Task Force (USPSTF) is an independent panel of national experts in prevention and evidence-based medicine. Their recommendations “are based on a rigorous review of existing peer-reviewed evidence and are intended to help primary care clinicians and patients decide together where a preventive service is right for a patient’s needs.”3
The UPSTSF’s recommended preventive health services for older adults include:4
Mental health, cognitive health and substance use:
- Check for depression.
- Check for tobacco use.
- Check for alcohol misuse.
- Check for signs of cognitive impairment.
Safety and functional ability:
- Ask about falls and fall history. Covered by Medicare Annual Wellness Visit for adults over 65.
- Check for signs of functional impairment. This includes ability to manage activities of daily living (walking, dressing, bathing), instrumental activities of daily living (transportation, shopping, meal prep and medication management), vision, hearing and cognitive abilities. Covered by Medicare Annual Wellness Visit.
- Assess home safety.
- Check for signs of elder mistreatment.
Physical health:
- Screen for high blood pressure. Annually after age 40.
- Screen for high cholesterol. Covered every 5 years for adults aged 40-75.
- Screen for obesity.
- Screen for abnormal blood glucose/type 2 diabetes. Recommended for obese adults aged 40-70. Medicare covers annual screens for people with risk factors.
- Screen for osteoporosis. Recommended for women over 65. Covered once every 2 years by Medicare.
- Screen for hepatitis C. Covered at least once by Medicare for adults born between 1945-1965. May be covered more often for those with additional risk factors.
- Screen for HIV and other sexually transmitted infections. HIV screen covered annually by Medicare. Recommended for those aged 15-65 and older with increased risk factors for infection such as men who have sex with men, people with multiple partners and people with past or present injection drug use. Sexually transmitted infection risk assessment is covered as part of the Medicare Annual Wellness Visit and Medicare covers testing if a clinician determines risk factors are present.
Cancer screening
- Screen for colorectal cancer. Recommended routinely (every 10 years) for adults 50-75, based on individualized decision for adults aged 76-85 and not recommended for adults 86 or over.
- Screen for breast cancer. Recommended every 2 years for women aged 50-75. Medicare covers annual screening mammograms.
- Screen for cervical cancer. Not recommended for women aged 65 and over who have had adequate prior screening and are not at high risk, or women who have had a hysterectomy for non-cancer reasons. Medicare covers a Pap smear every 24 months for women deemed low-risk, and annually for those deemed high-risk.
- Screen for lung cancer. Medicare covers annual screening for people aged 55-77 with a smoking history and who currently smoke or have quit within the past 15 years.
- Screen for prostate cancer. Medicare covers a PSA test and digital rectal exam annually.
Vaccinations:
- Influenza. Recommended annually, in the autumn, by the Centers for Disease Control and Prevention (CDC).
- Pneumococcal disease (“pneumonia vaccines”). Recommended once after age 65.
- Shingles (herpes zoster). Recommended by the CDC for most adults aged 50 and over. The two-dose Shingrix injection is administered over a course of up to 6 months, and re-vaccination is not recommended. Shingrix is covered under Medicare Part D.
- Tetanus-diphtheria (Td) and tetanus-diphtheria-pertussis (Tdap). The CDC recommends a Td booster shot every 10 years for all adults, and one dose of Tdap, which is especially important for those who will be around young babies. Both are covered under Medicare Part D.
Medications for prevention
- Aspirin for prevention of cardiovascular disease and colorectal cancer.
It’s also a good idea to have regular eye exams, as aging increases the risk of glaucoma and cataracts, and vision issues also change with age. The American Academy of Ophthalmology suggest a baseline screen by age 40, and then consultation with a doctor about the frequency of follow-up tests. The general recommendation is for annual vision screenings for those who wear contacts or glasses, and vision screenings every other year, otherwise.5
Oral health is important to monitor, especially since the medications many older adults take—like antihistamines, diuretics and antidepressants—may have a negative effect on dental health. A periodontal exam that includes an x-ray of the jaw is recommended at one of the recommended twice-yearly dental cleanings.6
While hearing loss may be a natural part of aging, it also may be caused by infection or another medical condition and therefore be treatable. Older adults should consider getting an audiogram—a test that checks hearing at a variety of pitches and intensity levels—every 2 to 3 years.7
Other tests that may be advisable include a check of thyroid-stimulating hormone (TSH) levels to screen for thyroid problems, and an annual full-body exam from a dermatologist to check for new or suspicious moles that could be skin cancer.8
Medicare covers a 1-time preventive care visit within the first 12 months of Medicare Part B coverage called “Welcome to Medicare” that includes a thorough review of medical and social history, a BMI (body mass index) calculation, a simple vision test, an assessment for depression and an opportunity to talk about advance directives. The “Welcome to Medicare” visit may result in education, counseling and a written plan for an applicable schedule of preventive services.9
Most preventive services recommended for older adults do not need to be addressed every year, and not all apply to every senior. Help ensure healthier aging by checking with a doctor about applicable, proven preventive health services.10
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Sources:
1Leslie Kernisan, “26 Recommended Preventive Health Services for Older Adults,” Better Health While Aging, last accessed October 19, 2022.
2Kernisan, “26 Recommended Preventive Health Services for Older Adults.”
3Kernisan, “26 Recommended Preventive Health Services for Older Adults.”
4Kernisan, “26 Recommended Preventive Health Services for Older Adults.”
5“The Health Tests Seniors Need,” Healthline, last accessed October 19, 2022.
6“The Health Tests Seniors Need.”
7“The Health Tests Seniors Need.”
8“The Health Tests Seniors Need.”
9“Your Guide to Medicare Preventive Services,” Centers for Medicare & Medicaid Services, last accessed October 19, 2022.
10Kernisan, “26 Recommended Preventive Health Services for Older Adults.”
This information is provided for educational purposes only. It is not to be used for medical advice, diagnosis or treatment. Consult your healthcare provider if you have questions or concerns.
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