Preventative Screenings and Exams are the Key to Good Health

The rise of preventative medicine has shown that a patient’s quality of life can be enhanced with regular healthcare screenings and exams. Preventative medicine can also save money for insurance companies such as Medicare.

Medicare was established in 1965 as an acute care insurance policy to cover illness and injury. Medicare did not pay anything to help keep Medicare recipients well when it was established, but the program has evolved with healthcare to include coverage for a preventative healthcare program for every Medicare enrollee.

Jeffery Kerr, DO, a nationally recognized geriatrician and the medical director of the emergency department at Texas County Memorial Hospital, sees a majority of Medicare-covered patients in the hospital and in his nursing home practice. He is a believer in the benefits of utilizing the preventative coverage provided by Medicare.

“Preventative medical services are the most underutilized part of the Medicare program,” Kerr said. “But preventative screenings and exams are the key component to the Medicare program and helping beneficiaries maintain their health and quality of life.”

For new Medicare enrollees, a first-time physical exam called the “Welcome to Medicare Physical” starts each Medicare recipient on the path of preventative healthcare. Eighty percent of the cost of this exam is covered during the first 12 months that a person is enrolled in Medicare Part B.

During the “Welcome to Medicare” exam, the healthcare provider will record medical history, check blood pressure, vision, weight and height. The healthcare provider will make sure the patient is up-to-date with preventive screenings and services, such as cancer screenings and shots. Depending on a person’s general health and medical history, further tests may be ordered if necessary. For example, a person at risk for an abdominal aortic aneurysm may get a referral for a one-time screening ultrasound at their “Welcome to Medicare” physical exam.

A screening lipid panel to evaluate cholesterol and triglycerides is covered each year for Medicare recipients. Good cholesterol levels decrease risk of heart attack and stroke.

“Our genetics play a big role in our cholesterol and triglycerides,” Kerr explained. “You can be thin and in shape and still have elevated cholesterol levels.”

Elevated levels of cholesterol and triglycerides in the arterial walls create sticky areas for blood to attach and create clots. These clots can proceed to clog arteries—usually in the brain, heart and legs.

Screening colonoscopies are covered every 10 years by Medicare. Colonoscopies can find polyps and tumors. Because some colon cancers originate in polyps, the polyps founds during screening colonoscopies can be removed during the screening exam.

Lipid panels and colonoscopies are two part of preventative healthcare covered by Medicare for men and women. There are also preventative screenings recommended and covered specifically for men and for women.

Men and women may also receive a bone mass measurement, medically referred to as a Dexascan, covered by Medicare. The criteria for Dexascan vary for men and women. Because women are more likely to experience bone loss or osteoporosis, a healthcare provider may order a Dexascan every two years as part of a preventative medicine program.

“Osteoporosis can creep up on a person, and many times is not recognized until that person fractures a hip or has a vertebrae crumble,” Kerr said.

Kerr noted that bone health can be improved with some medications or treatment plans prepared by a healthcare provider.

Specifically for men are the annual prostate screening antigen (PSA) with a digital rectal exam (DRE) and a testosterone level evaluation.

“Prostate cancer can be slow growing without symptoms,” Kerr explained.

Often, the first sign of prostate cancer is bone pain. At that point, the cancer has spread to the bone and is incurable.

“A PSA is a simple blood test, and the DRE is performed at the same time to evaluate the size of your prostate,” Kerr said.

A testosterone level test is also a blood test; checking for the level of androgen in blood. According to Kerr, a normal testosterone level can increase the quality of life for men of all ages.

Women enrolled in Medicare can receive screening mammograms, gynecologic exams and hormone therapy in the preventative portion of Medicare coverage.

“Screening mammograms have proven that breast cancer does not have to be deadly,” Kerr explained. “The benefits far outweigh the risks.”

Mammograms are covered every year in the Medicare program. A screening mammogram can find nodules that cannot be felt by a patient.

The annual female gynecologic exam includes a test to find abnormal cells in the cervix that are or may become cancerous, commonly known as a pap smear. This test can also determine the level of hormones circulating in a woman’s body. A rectal exam may also be included annually to evaluate the stool for occult blood, which can be a warning sign for cancer.

“A woman’s healthcare provider can determine the frequency of gynecological exams based on the needs of the woman and her health history,” Kerr said.

Hormone therapy may also be a part of a female Medicare recipient’s preventative health plan as evaluated and prescribed by a healthcare provider. Low estrogen levels can cause fatigue, vaginal dryness, urinary problems and decreased sex drive.

Kerr stressed the importance of each Medicare enrollee having a relationship with a primary care doctor. “If you don’t have a regular healthcare provider or have not seen your doctor about a preventative program, I encourage you to do so,” Kerr said.

As a long-time physician at TCMH, Kerr has worked closely with the hospital’s physicians and mid-level providers.

“TCMH has healthcare providers that can work with anyone who needs to set up a preventative care program,” Kerr said, noting that all of the preventative screening tools are available at TCMH, too.

“Many older adults do not like to travel far from home to get the healthcare they need, so we are very fortunate to have the staff and services available in Texas County to help our elderly stay healthy when they get started on a preventative healthcare plan,” Kerr said.