It's Never Too Late to Reduce Your Health Risks

Reduce Your Health Risks

How often have you had a wellness checkup with your doctor?

Question 2: 

How much do you know about the disease prevention and risk reduction section of the Affordable Care Act passed by Congress in 2010?

Make a Difference in the Rest of Your Life

How important is prevention—and reducing your risk—of serious illness? This question is addressed to you, whether you are 32 or 72, and to your family.

The easy answer is: Very Important.

The honest answer, if you are like many Americans, “Not Too Important Now”—until you or a family member is ill and your doctor suggests that perhaps you or your family member failed to get a vaccination or a screening test, or to change unhealthy habits like smoking or overeating.

And then it may be too late to say “Very Important.” The illness that caused the doctor visit may be a chronic illness such as diabetes or heart disease that developed slowly with very few symptoms, or a serious infection or cancer that might have been prevented.

As you consider how important this is to you, the contents that follow will help you in your decision. This section of the Patient Resource Center is designed to identify the immunizations, the screening tests, and the changes in health habits that can prolong and improve the quality of your life or that of a family member. The focus is on the areas of prevention and risk reduction most valuable to people over 65, but the recommendations are applicable to adults of any age.

Why is the focus on people over 65? Because the Affordable Care Act, passed by Congress in 2010, provides prevention and risk reduction services for all Medicare beneficiaries as of January 1, 2011—free of charge to those beneficiaries. If you are not yet covered by Medicare, you may soon see similar coverage from other health insurers.

What is now completely covered by Medicare?

  • An Annual Wellness Visit (AWV), including Personalized Prevention Plan Services
  • Screening procedures for:
    • Osteoporosis
    • Cervical cancer
    • Lipid disorder (e.g., high cholesterol)
    • Colorectal cancer
    • Diabetes (only in those with high blood pressure)
    • HIV (for people at increased risk or who ask for the test)
    • Breast cancer
    • Alcohol misuse
    • Obesity
    • Depression
  • Immunizations against:
    • Influenza
    • Pneumonia
    • Varicella Zoster
    • Tetanus, diphtheria, and pertussis (Tdap)
  • Counseling for:
    • Aspirin use
    • Smoking cessation or prevention
    • Alcohol misuse
    • Obesity

What is included in an initial Annual Wellness Visit?
The initial Annual Wellness Visit covered completely by Medicare for persons 65 and over provides a detailed list of services. Most of these are services that any adult should have regularly. In a more traditional history and physical exam, your doctor may include additional tests or examinations. The purpose of the Annual Wellness Visit is to specifically identify major areas of health risk and help you set up appropriate follow-up care. Here is what is covered:

  • Your medical and family history
  • Establishment of a list of current doctors and other suppliers that regularly provide your medical care
  • Measurement of your height, weight, Body Mass Index (or waist circumference, if appropriate), blood pressure, and other routine measurements as deemed appropriate, based on your medical/family history
  • Detection of any cognitive impairment that you may have, such as an early stage of Alzheimer’s Disease
  • Review of your risk factors for depression, including current or past experiences with depression or other mood disorders, often based on the use of an appropriate screening instrument
  • Review of your ability to carry out activities of daily living and maintain a level of safety
  • Establishment of a written screening schedule for you, such as a checklist for the next 5 to 10 years, based on recommendations of the United States Preventive Services Task Force (USPSTF) and the Advisory Committee on Immunization Practices (ACIP), as well as your health status, screening history, and appropriate preventive services covered by Medicare
  • Establishment of a list of risk factors and conditions for which follow-up care is recommended or under way, including any mental health conditions
  • Establishment of a list of treatment options for you, if necessary, and their associated risks and benefits
  • Providing you with personalized health advice and a referral, as appropriate, to health education or preventive counseling services or programs aimed at reducing identified risk factors and improving self-management, including weight loss, physical activity, smoking cessation, fall prevention, and nutrition
  • MLN Matters® Number: MM7079 Related Change Request Number: 7079

What would be included in a Subsequent AWV?
In subsequent Annual Wellness Visits, your doctor would provide the following services to a Medicare beneficiary:

  • An update of your medical and family history
  • An update of the list of current doctors and other suppliers that are regularly involved in providing medical care to you
  • Measurement of your weight (or waist circumference), blood pressure, and other routine measurements as deemed appropriate
  • Detection of any cognitive impairment that you may have
  • An update to your written screening schedule
  • An update to the list of risk factors and conditions for which interventions were recommended or under way
  • Providing you with personalized health advice and a referral, as appropriate, to health education or preventive counseling services or programs

Who selected the screening and other services provided?
The screening and counseling services listed were recommended for adults aged 65 and older by the USPSTF, which conducts scientific evidence reviews of a broad range of clinical preventive services and develops recommendations for primary care clinicians and health systems. The Affordable Care Act includes only those services that received the highest ratings of evidence, namely an A or B. To learn more about these recommendations, Click Here. [link to SERVICES activity]

The U.S. Advisory Committee on Immunization Practices (ACIP) issues recommendations for the administration of vaccines to children and adults. It is also a well-respected independent body of experts with long-standing experience in promulgating firmly grounded recommendations. To learn more about the recommendations for fully covered immunizations for Medicare beneficiaries, Click Here.



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