Men and Medicare – What You Should Know

After age 50, men have an increased risk of developing certain cancers, like prostate and colorectal cancer. In fact, colorectal cancer is the number two leading cause of cancer related deaths—and risk only goes up with age according to Men also have higher rates than women for heart disease, diabetes and stroke, three of the top 10 causes of death.

Luckily, regular screening tests are the most effective way to reduce risk. For men on Medicare, being proactive about health is easy, as the program covers many preventive services and screenings at little or no cost. Here’s some information on men’s health and Medicare, and how you can benefit from the program.

Medicare covers a variety of preventive services and screening tests designed to identify problems early, when treatment can work the best. Some of the services men can take advantage of right now include:

  1. Prostate and colorectal cancer screenings
  2. Diabetes screenings
  3. Cardiovascular screenings

Prostate and Colorectal Cancer Screenings Medicare Part B covers a variety of prostate and colorectal cancer screening tests to help identify precancerous growths when treatment is most effective. A digital rectal exam is covered (less deductible and coinsurance) once every 12 months to detect prostate cancer. Medicare also pays for a prostate specific antigen (PSA) test at 100 percent, with no cost to you.

Men who are considered high risk for colorectal cancer can receive a colonoscopy test and enema paid in full every 24 months, or every 48 months for those of average risk. Average risk for developing colorectal cancer means no personal or family history with polyps, inflammatory bowel disease or hereditary colorectal cancer. In addition, Medicare Part B pays for a multi-target DNA stool test every 3 years, and a fecal occult blood test annually. While most screenings are covered 100 percent, if a biopsy or removal is required, you may be responsible for a copay or coinsurance.

Diabetes Screenings Medicare Part B covers the full cost of screenings to check for diabetes at 100 percent. Men who are considered high risk are eligible for 2 screenings per year. High risk factors include the following:

  1. High blood pressure
  2. History of abnormal cholesterol and triglyceride levels
  3. Obesity
  4. History of high blood sugar

You may also receive 2 tests per year if any 2 of the following apply to you:

  1. Over 65 years old
  2. Overweight
  3. Family history of diabetes
  4. History of gestational diabetes

Cardiovascular Screenings and Stroke Prevention Medicare Part B also covers screening blood tests for cholesterol, lipid and triglyceride levels at 100 percent every 5 years. These screenings are an important part of detecting conditions that may lead to a heart attack or stroke.

Your doctor may recommend more tests than Medicare covers. Be sure to ask questions to understand why your doctor is recommending services, and if Medicare will pay for them or if you will be responsible for paying all or some of the costs.