Medicare Advantage preventive care

Senior woman looking at produce in grocery store

By focusing on preventive care and wellness, we can work together to help you avoid illness and stay well. Our members receive preventive screenings and other valuable services, at no additional cost when using an in-network provider*. Review your summary of benefits and coverage for network provider details.

Office visits

Welcome to Medicare visit

As soon as you enroll in Medicare Part B, you can schedule your welcome to Medicare visit. This visit is covered at no cost to you by Medicare.

During this visit, your primary care physician (PCP) will record your medical history and check your vision, blood pressure, and weight and height to measure your body mass index. It's a great way to get up-to-date on important screenings and shots and to talk with your doctor about your family’s medical history and ways to manage your health.

Annual wellness visit

At this visit, preventive services and more are covered at no ($0) out-of-pocket costs to you when received by an in-network provider. Review your summary of benefits and coverage for network provider details.

  • Breast cancer mammography screening
  • Colorectal cancer screening
  • Diabetes screenings, monitoring supplies and self-management training

Annual physical

During this visit, your PCP will take a medical/family history and perform a head-to-toe general health assessment with hands-on examination of all the body systems.

Did you know?

When you are new to Medicare Advantage you can schedule your welcome to Medicare visit AND an annual wellness visit.

  • Both visits are covered at no cost ($0) to you during your first year of enrollment.
  • The annual wellness visit and all PCP visits are covered at no cost ($0) to you.

 

Transportation

We cover 24 one-way rides each year to medical appointments or to the local pharmacy to help keep you well. If you would like a ride to an upcoming appointment, call the Customer Care Center at 877-301-3326 (TTY:711) or visit our extra benefits page to set up this service at no additional cost to you.

Telehealth

Telehealth can be used to assess your risk for certain health conditions. It may also be used for your annual preventive visit or for other appointments if you do not need lab work or vaccines. Telehealth annual preventive visits should be done using audio and visual technology (a smart phone or computer). Talk with your PCP and ask if a telehealth appointment is right for you.

Other preventive services

All preventive services are listed in your Evidence of Coverage. See the Medical Benefits chart in Chapter 4, Section 2.1. You will see an apple listed next to the preventive services in the benefits chart.

Non-preventive care

Non-preventive care is care given to manage chronic or acute (sudden) illness. If you receive non-preventive care at your PCP's office, you'll have a $0 copay. Many other non-preventive services will have out-of-pocket costs (copays). Examples include, but are not limited to:

  • Diagnostic tests and screenings: These are non-routine tests and screenings. For example, if something suspicious is found on your screening and your provider needs additional information, follow-up tests will not be considered as preventive care.
  • Specialist visits: Visits to a specialist (gastroenterologist, orthopedist, neurologist, podiatrist, etc.) for a particular problem are not covered as preventive care. 

Caregiving and Burnout

Anyone can be a caregiver

Many don’t even realize they are caregiving. Over 50 million of us are a caregiver during a given year, according to the AARP. Whether you work in a field where you are paid to be a caregiver or you have a loved one in need, caregiving and burnout go hand-in-hand. When your needs are put on hold for others, it can be detrimental to: 

  • Health
  • Relationships
  • State of mind 

Take care of yourself. Give yourself a break! Use the following strategies a few hours a week to reduce the effects of compassion fatigue.

  • Maintain personal relationships
  • Prioritize leisure activities that give you enjoyment
  • Find ways to pamper yourself
  • Make yourself laugh
  • Ask for help

If you are feeling overburdened by caregiving, consider joining a support group such as the Family Caregiver Alliance.

In-home support from Papa Pals

Papa connects you with screened and trained Papa Pals who provide 120 hours per year of in-home or virtual assistance each month with light housework, organization, technology and transportation. Call 1-888-840-1609 (TTY: 711), or visit our extra benefits page to enroll.

Caregiving and burnout resources


What is Medicare Advantage?

Medicare Advantage (MA) health plans, also called Part C plans, combine Original Medicare (Parts A and B) and often Part D into one plan with a network of providers. In addition to services covered by Original Medicare (Parts A and B), your MA plan may provide many other health care services at no additional cost to you. Visit our extra benefits page to see the added services we provide you at no additional cost.

Medicare Part A covers care at hospitals and other facilities. You typically pay a deductible and coinsurance and/or copayments.

Part A insurance covers things like:

  •  Inpatient hospital stays
  •  Skilled nursing care
  • Hospice care
  • Limited home health-care services

 

In general, Medicare Part B covers your outpatient (office-based) medical care.

Part B insurance covers things like:

  • Doctor visits
  • Outpatient care
  • Medical supplies
  • Some preventive services
  • Vaccines
  • Visit medicare.gov for a list of preventive & screening services covered by Part B

Medicare Part D covers most of your medications and some vaccinations. There are times when you will need to use your Part B coverage for prescriptions, vaccinations and other items at the pharmacy.

Part D insurance covers things like:

View our Medicare disclaimer.
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Updated: 1/30/23