St. Luke’s Director of Patient Financial Services Deborah Knight notes, “These are important benefit changes for our senior patients. In the past, Medicare paid for coverage of only limited preventive services. Having Medicare coverage for additional preventive health services will help patients identify potential health problems before they become critical and costly.”

The initial preventive physical examination must be performed no later than six months after the individual’s first coverage period begins under Medicare Part B, and it applies only to those whose coverage begins on or after January 1.

The physical exam is intended to provide education and counseling about preventive services that may be needed. It includes a measurement of height, weight and blood pressure, a screening EKG and a review of the patient’s medical and social history. The exam will review the patient’s potential risk factors for depression, functional ability and level of personal safety. It also includes education, counseling and referral to screening and preventive services currently covered under Medicare Part B.

Expanded Medicare coverage of screening tests for cardiovascular disease includes a total cholesterol test, a cholesterol test for high density lipoproteins (HDL), and a triglycerides test. These three tests should be performed as part of a “panel” – a group of related blood tests conducted at the same time from the same sample – and should be performed only following a 12-hour fast. While the tests should be performed as a panel, they also are available as individual tests. Medicare will reimburse for each test once every five years, regardless of whether it is performed as part of a panel or as an individual test.

Coverage also has been added for diabetes screenings, in recognition of the fact that approximately half of all diabetes cases occur in people older than age 55. These screenings will encourage early access to quality treatment and health care education, both of which are critical for seniors with diabetes.

Patients who recently have become eligible for Medicare coverage should schedule an appointment with their physicians as soon as possible, in order to receive coverage for their initial physical before their six-month eligibility deadline passes. If you need help finding a personal physician, please call (415) 821-DOCS, or visit our website at www.stlukes-sf.org and click on the link for “Find a Physician.”

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