Marci's Medicare Answers
My doctor just told me that I am pre-diabetic, and need to come back for another screening in six months. Will Medicare pay for it?
Yes. If you have been diagnosed with pre-diabetes, Medicare will cover two diabetes screening tests every calendar year. People who are considered at risk of diabetes are eligible for one screening every 12 months. You are considered at risk if you have hypertension, dyslipidemia (a metabolism disorder) or high cholesterol, have a prior blood test showing low glucose (sugar) tolerance or are obese (a body mass index of 30 or above). You are also considered at risk if you meet two of the following conditions: are overweight (body mass index between 25 and 30), have a family history of diabetes, have a history of diabetes during pregnancy (gestational diabetes) or have had a baby weighing over nine pounds, or are 65 or older. Medicare will pay for 100 percent of its approved amount for the tests even before you have met your Part B deductible..
I get sunburned very easily, and have been getting screened for skin cancer since I was young. I will be eligible for Medicare this summer, and would like to know if it will cover these screenings.
No, Medicare will not cover screenings for skin cancer. If, however, you see a suspicious-looking mole, you should make an appointment with your doctor as soon as possible. Medicare will cover a diagnostic doctor’s visit and any diagnostic tests your doctor considers medically necessary. You may be able to find a doctor who will give you a free skin cancer screening by visiting the American Academy of Dermatology’s web site (www.aad.org/public/exams/screenings/index.html).
My mother’s friend, who has both Medicare and Medicaid, was told that she would lose her Medicaid if she didn’t join a particular insurance plan. My mother has both Medicare and Medicaid, too, and we don’t know what to do. Is this true?
No. If the person who told this to your mother’s friend was an insurance broker, he or she was acting illegally and committing marketing fraud. There are rules that insurance plans and brokers must follow when selling their plans. For example, they are not allowed to enroll you in a plan over the phone if they called you, and they cannot visit you in your home without an invitation. If you suspect marketing fraud, save all proof (such as a business card or marketing materials) and report the activity to your State Insurance Department or State Attorney General Consumer Helpline.
Marci's Medicare Answers is a service of the Medicare Rights Center (www.medicarerights.org), the nation's largest independent source of information and assistance for people with Medicare. To subscribe to "Dear Marci," MRC's free educational e-newsletter, simply e-mail firstname.lastname@example.org.