Women and Medicare

With elevated risk for certain types of cancers and high rates of chronic disease, women have unique health requirements. For many women age 65 and older, Medicare is an important piece of the puzzle, offering screenings and other services designed to identify or treat these conditions at little or no cost. Here’s some information on women’s health and Medicare, and how you can benefit from the program.

Medicare covers many preventive services and screening tests designed to identify problems early, allowing treatment to work best. Some of the services women can take advantage of right now include:

  • Annual wellness visit
  • Bone mass measurement
  • Cervical cancer screenings
  • Mammogram
  • Cardiovascular screenings

Pelvic Exams and Pap Smears

Medicare covers 100 percent of the costs of a pelvic exam that can help detect fibroids or ovarian cancers. The benefit also includes a clinical breast examination for detection of breast cancer. Most women are entitled to receive one pap smear every 24 months that helps identify vaginal or cervical cancer. For those at high risk for developing these types of cancers, and those who recently received an abnormal pap smear, Medicare pays for a new pap smear every 12 months.

Mammograms and Mastectomy

Medicare Part B pays 100 percent of a screening mammogram once every 12 months and 80 percent of a medically necessary diagnostic mammogram. If a mastectomy is needed, Medicare Part A covers the cost of surgically planted breast prostheses (less Part A deductible and coinsurance) and Medicare Part B pays for external breast prostheses along with a post surgical bra and breast reconstructive surgery (less Part B deductible and coinsurance).

Women and Heart Disease

Medicare covers many services designed to prevent, diagnose, treat or manage heart disease in women. A thorough preventive visit and annual wellness check is covered 100 percent, followed by a cardiovascular screening once every 5 years and two diabetes screenings per year along with clinical lab tests. In addition, medical nutrition therapy and diabetes management support is covered 80 percent.

Bone Mass Measurement and Osteoporosis Drugs

Medicare Part B covers one bone density test every 24 months for qualified women who are at risk for developing osteoporosis. If qualified, you pay nothing for these services. Note: If your doctor or health care provider recommends services beyond what Medicare covers, you may have to pay some or all of the costs.

Medicare Part A and Part B pay for an injectable drug designed to treat osteoporosis in women. Some women may also be eligible for a home visit from a nurse to inject the drug (Part B deductible and coinsurance apply to the costs of the drug, but you pay nothing for the home visit).

 

Resources:

https://www.medicare.gov/coverage/mammograms.html

https://www.medicareinteractive.org/get-answers/medicare-covered-services/preventive-care-services/medicare-coverage-of-pap-smears-pelvic-exams-and-physical-breast-exams

https://www.medicare.gov/your-medicare-costs/costs-at-a-glance/costs-at-glance.html

https://www.medicare.gov/coverage/osteoporosis-drugs-for-women.html

https://www.medicare.gov/coverage/bone-density.html

https://www.medicare.gov/coverage/cardiovascular-disease-screenings.html

 

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