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What Men Need to Know About the Changes to Medicare

4 minute read

By natadm

You only have a few more days to enroll or add additional coverage to your Medicare plan. If you’re a male who is suffering from a chronic disease, there are changes that you should be aware of.

It’s not a surprise that men and women face different health challenges. Studies suggest that males are more at risk for cardiovascular disease, lung cancer, and, of course, prostate cancer.1 Protecting yourself is easy as Medicare provides coverage for screenings that can help men with early detection.

Men will be affected by Medicare’s latest changes when 2019 arrives. If you’re suffering from a heart condition, respiratory disease, or depression, the following are the important coverage details men need to know. Remember open enrollment ends on December 7, and if you don’t act now, you may have to pay a costly penalty.

Cardiovascular Disease: Preventative Care Is Covered

In the United States, heart disease is the leading cause of death among men. Under Medicare Part B, screening test for cholesterol, lipid, and triglyceride levels are 100 percent covered – which can be life-changing.2

Medicare does not cover any prescription costs for heart disease. So, if you go without a screening and do not take the necessary measures to prevent heart disease, you could end up spending thousands of dollars in out-of-pocket expenses. Medicare Part B will cover intensive cardiac rehabilitation programs for those who’ve had a heart attack or stroke.

The best option for your health and your finances is to undergoing screenings. Those with Medicare Part B are covered for the latter screening tests once every five years – and you do not need to show signs of the disease to qualify.3

Behavioral Therapy, a therapy that can help to lower your risk for cardiovascular disease, is also covered. One visit to the doctor per year to discuss preventive heart disease measures is covered under the Medicare Part B Plan.

Preventive Services for Respiratory Disease Are Covered

70,000 men die each year from respiratory diseases such as lung cancer or COPD, according to Men’s Health.4 Early preventive screenings can significantly improve a person’s overall outlook. Fortunately, Medicare Part B offers 100 percent coverage for a lung cancer screening with Low Dose Computed Tomography once per year.

It’s important to know that a person does have to meet the following criteria to qualify for screening coverage:

  1. You aren’t showing any signs and symptoms of lung cancer
  2. You’re a current smoker or have quit within the last 15 years
  3. You smoke an average of one pack of cigarettes a day for 30 years
  4. Your doctor has ordered you to get screened

Also, those who are suffering from COPD, Medicare Part B will cover 20 percent of a comprehensive pulmonary rehabilitation program but only if have a referral from a doctor.5

Prostate Cancer Screening Is Covered

Medical Part B covers prostate cancer screening, which is one of the most common forms of cancer among men in the United States. Medicare Part B6 offers 100 percent coverage of a Prostate Specific Antigen (PSA) test once every 12 months for men over 50. Medicare also covers 20 percent of the cost of a yearly digital rectal exam. Prostate Cancer screening is important because many men with prostate cancer do not experience any symptoms.

However, if you’re younger than 55 or older than 69, you should avoid getting an annual screening because the effects of test could be more harmful than helpful, according to the U.S Preventive Services Task Force (USPSTF).7

Depression-Screening Test Is Covered

If you’re suffering from depression, it’s important to know that Medicare Part A and Part B do not offer coverage for antidepressants. If you don’t have Part D coverage or a Medicare Advantage plan8 (an alternative to Part D), you could be paying way too much for your antidepressant medications.

If you haven’t been diagnosed with depression, there is a depression-screening test that can determine whether symptoms such as fatigue, irritability, and helplessness feelings are associated with the illness. Those with Medicare Part B are 100 percent covered for this test once per year; the screening must be done in a primary care facility such as a doctor’s office.

Mark Your Calendars: Medicare Enrollment Is Ending Soon

Medicare changes each year. And if you’re not aware of these changes, it could affect your coverage and your finances.

Whether you’re looking to enroll or make changes to your current plan, you need to know that the deadline is coming up fast. If you don’t act now, you could end up paying hundreds or thousands of dollars in out-of-pocket expenses.

The open enrollment period ends on December 7. So, right now is the perfect time to research new coverage options, like Medicare Advantage plans.

Like anything, it’s always a good idea to be aware of the latest research. We recommend comparing at least 3 or 4 options before making a final decision. Doing a search online is typically the quickest, most thorough way to discover all the pros and cons you need to keep in mind.

natadm

Contributor

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