Guest Blog: Improving access to preventive services for seniors

Dr. Ed Pullen is a family physician who sees patients at Sound Family Medicine in Puyallup, WA and blogs at DrPullen.com.

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A nice surprise buried in the health care reform bill is that starting next year, Medicare patients will be able to receive annual preventive care exams that are paid for by the program. It may come as a surprise to those of you with private insurance plans who think of coverage of an annual exam as routine, but up until now Medicare has only covered a “Welcome to Medicare” exam in the first year after turning 65. Also, many preventive services like colonoscopy and mammography were either not covered, or subject to high co-payments and deductibles. This situation has always seemed backwards to me. I can make a pretty good argument that an annual physical exam for a 27 year old man is not needed, but it is almost always a covered benefit in any plan the young insured patient has through an employer. Older adults, on the other hand, are far higher risk for cancer, heart disease, diabetes, hypertension, depression, and safety at home issues than are young adults. So I am pleased that preventive services for older and more vulnerable adults will be covered starting in 2011. Leslie Alderman nicely discussed the details of this new coverage in a recent New York Times article.

Starting Sept 23, 2010, all new insurance plans, or current plans which make certain changes, will be required to provide coverage for preventive services recommended by the U.S. Preventive Services Task Force as category "A" or "B" ratings (moderate or high certainty of at least a moderate net health benefit). Beginning Jan. 1, 2011, Medicare will also cover these services with no co-payment or deductible.

This is good news, and should make it much easier for primary care physicians to convince older patients, some of whom currently choose between purchasing shelter, food, or medicine on fixed incomes, to receive evidence-based preventive care.