Approximately 5.5 million people with traditional Medicare used one or more free preventive benefits offered by last year’s Affordable Care (healthcare reform) Act, as of June 2011, according to the Centers for Medicare and Medicaid Services. That’s 16 percent – or one in six – of the more than 33 million Americans who had traditional Medicare. Those benefits include mammograms, bone density screenings and screenings for prostate cancer.

 

Beginning Jan. 1, 2011, the Affordable Care Act eliminated Part B coinsurance and deductibles for recommended preventive services. The law also provided for Annual Wellness Visits at no cost to beneficiaries.

 

Preventive services now provided with no out of pocket costs by Medicare, along with their 2011 utilization rates (between January 1 and June 10, 2011) are: 

 

Services previously subject to both the Part B deductible and coinsurance/copayment:

  • Bone mass measurement (1,549,056).
  • Hepatitis B (HBV) vaccine (193,383).
  • Tobacco cessation counseling (20,730).
  • Medical nutrition therapy (data not available).

 

Services previously exempt from the Part B deductible, but subject to coinsurance/copayment:

  • Pap tests (that require physician interpretation)  (508,238).
  • Pelvic examination (535,098).
  • Screening Mammography (2,326,088).
  • Most screening procedures for colorectal cancer.  (472,075).
  • Ultrasound screening for abdominal aortic aneurysm (data not available).

 

Services previously exempt from both the Part B deductible and coinsurance/copayment:

  • Pap tests (that do not require physician interpretation)  (582,870).
  • Fecal occult blood test for colorectal cancer screening (466,657).
  • Prostate-specific antigen (PSA) test (1,137,131).
  • Diabetes screening test (data not available).
  • Cardiovascular disease screening test (data not available).
  • Seasonal influenza virus vaccine (data not available).
  • Pneumococcal vaccine (data not available).
  • Human Immunodeficiency Virus (HIV) screening (data not available).

 

The fecal occult blood test was always free, and the Part B coinsurance/copayment continues to apply to barium enemas, as well as to a screening colonoscopy if an abnormality is found and treated during the procedure, according to CMS. Total utilization for colorectal cancer screening was 928,520 from January through June 10, 2011.

 

A recent CMS study showed that roughly 70 percent of Medicare beneficiaries had at least one chronic condition in 2008. As many as 38 percent had between two and four chronic conditions, and 7 percent had five or more. Patients with multiple chronic conditions are 60 percent more likely to be hospitalized than a typical beneficiary with a single chronic condition, and 30 percent more likely to require home health services, with an average of 76 percent more office visits a year per patient.

 

Comments are closed.

Archives
Polls

Who do you think will win in the Monday Night BCS game?

  • The Tide (57%)
  • The Irish (43%)
Loading ... Loading ...