Medicare Advantage preventive care

senior couple holding hands while walking on a beach

By focusing on preventive care and wellness, we can work together to help you avoid illness and stay well. Dean Advantage members receive preventive screenings and other valuable services, at no additional cost when using an in-network provider*.  

What is Medicare Advantage?

Medicare Advantage (MA) health plans, also calledPart 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

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

 

Medicare Part B

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 Advantage Part D (MA-PD)

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:


Learn more about Medicare and Medicare insurance coverage at medicare.gov.

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 (BMI).

 

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.

This visit is also 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, the following preventive services, and more, are covered at no ($0) out-of-pocket costs to you when received by an in-network provider*:

  • 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.

Vaccinations

It is important to keep vaccines current: you may not have been vaccinated as a child or your immunity may have faded. Most importantly, vaccines help keep you safe from possible life-threatening, vaccine-preventable, diseases.

Medicare Part B covers these vaccines when received in your clinic:

  • Annual flu shot
  • Hepatitis B
  • Pneumococcal pneumonia
  • Tetanus shot, but only due to an injury


Medicare Part D covers these vaccines when received at a Prevea360 network pharmacy

  • Hepatitis A
  • Shingles
  • Td (tetanus and diphtheria) booster
  • Tdap (tetanus, diphtheria, and pertussis) booster


Your plan must include Part D for Part D vaccines to be covered.

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.

These 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. 


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.

*If your plan uses a provider network, review your summary of benefits and coverage for network provider details.

View our Medicare disclaimer.
H9096_prevea360.com
Updated: 3/1/22