Medicare Adds Preventive Benefits

As part of an emphasis on preventive medicine, Medicare will begin covering the initial physical examinations of patients who join the program after Jan. 1, Health and Human Services Secretary Tommy G. Thompson announced Tuesday.

“Prevention is one of my passions,” Thompson said.

In addition to the physical exam, Medicare will cover diabetes tests and screening for hearing and vision problems, high cholesterol and high blood pressure. Medicare was originally designed to offer financial support to the elderly and disabled who became ill or injured.

The new benefits will be funded through premiums for Part B of Medicare, which covers visits to doctors’ offices among other services. The Bush administration announced in September that Part B premiums, which by law cover about 20% of the program’s costs, would increase from $66.60 to $78.20 a month -- the greatest annual increase in the program’s 40 years.

“Ninety-nine percent of all Medicare dollars are spent on treating diseases,” Thompson said, with only 1% aimed at preventing them. The current program covers screening for a few serious illnesses, including breast cancer, colon cancer and osteoporosis. It also covers the cost of annual vaccines for flu and pneumonia.

The new preventive benefits were enacted as part of the sweeping Medicare prescription drug benefit law approved last year. In its fiscal 2005 budget, the White House Office of Management and Budget estimated Medicare Part B expenses at $144 billion, with about $30 billion covered by premiums paid by beneficiaries.

The government’s Centers for Medicare and Medicaid Services estimated that in the first year the new preventive services would cost between $20 million and $60 million each for the introductory exams.

Despite the cost, Kathleen King of the National Academy of Social Insurance, a nonprofit research organization that examines national social service policies, called the new Medicare coverage a welcome addition.

Coverage for the initial physical “gives you a baseline when you first get on the program,” she said. Patients get an outline of their overall health and the opportunity to work with doctors “before something goes wrong.”

Currently, Medicare patients often wait until they get sick before visiting a doctor.