How to Schedule & Use Your Preventive Care Benefits

Knowing what Medicare covers is the first step, but scheduling and using your preventive care benefits is what makes the difference for your health. Many Medicare beneficiaries have access to these no-cost services but never use them simply because they are not sure how to get started. Here is a simple guide to help you take action.

Step 1: Confirm Your Coverage

Before scheduling any preventive service, it is important to confirm how you receive your Medicare coverage:

• If you have Original Medicare (Part A and Part B), most preventive services are covered at no cost when your provider accepts assignment

• If you have a Medicare Advantage plan, your plan must cover all the same preventive services as Original Medicare and may offer additional benefits

• If you have a Medicare Supplement plan, it can help cover any out-of-pocket costs that may apply

Unsure which plan fits your needs the best, or not sure what your current plan covers? Your SGIA Benefit Consultant can review your coverage with you.

Step 2: Start With Your Annual Wellness Visit

Your Annual Wellness Visit is the best place to start. This visit is covered once every 12 months at no cost and gives your doctor a full picture of your health. During this visit your doctor can:

• Review your current health and medications

• Update your personalized prevention plan

• Identify which screenings and services you are due for

• Refer you to additional preventive services as needed

Think of your Annual Wellness Visit as your roadmap for the year; it helps you and your doctor stay on the same page and make sure nothing is missed.

Step 3: Know Which Screenings Apply to You

Not every screening is right for every person. Eligibility for certain screenings depends on your age, health history, and risk factors. During your Annual Wellness Visit your doctor can help identify which screenings are appropriate for you. Some screenings require a referral or a doctor's order, so it is always a good idea to ask during your visit rather than scheduling them separately.

Step 4: Find a Provider Who Accepts Assignment

To receive most preventive services at no cost, your provider must accept assignment. This means they agree to accept Medicare's approved payment amount as full payment. Before your appointment, always confirm that your provider accepts assignment to avoid unexpected costs.

You can search for providers who accept Medicare at Medicare.gov. 

Step 5: Keep Track of Your Preventive Care

Preventive services are available on a schedule: some are covered once a year, others every two years or every five years. Keeping track of when you are next eligible for each service helps you stay on top of your health and avoid missing benefits you are entitled to.

A few simple ways to stay organized:

• Ask your doctor's office to remind you when you are due for a screening or visit

• Keep a simple list of the preventive services you have used and when

• Review your Medicare Summary Notice (MSN) to track services that have been billed to Medicare

Why This Matters

Preventive care only works when you use it. Scheduling your Annual Wellness Visit each year and staying current on your screenings and vaccinations gives you the best chance of catching health concerns early.

Your SGIA Benefit Consultant is here to help you understand your coverage, confirm which preventive services apply to you, and make sure you are getting the most out of your Medicare benefits all year long. Contact us today at 888-284-3314 or visit sgiamedicare.com.