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HEALTH MIND & BODY
Changes coming to Medicare in 2013
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Thursday, November 29, 2012 1:00 PM
Medicare will have several changes next year, including coverage of more preventive services.
Alcohol misuse counseling.
Behavioral therapy for cardiovascular disease.
Obesity screening and counseling.
Screening and counseling for sexually transmitted infections.
Coverage by Medicare depends on the provider accepting assignment, or payment, from Medicare, and the services must be provided in a setting like a primary care doctor's office.
Alcohol misuse. Medicare will cover one screening a year for alcohol misuse by people "who don't meet the medical criteria for dependency on alcohol," according to the Medicare Part B explanation. If the doctor determines alcohol is being misused, there can be up to four short counseling sessions a year in the doctor's office.
Behavioral therapy. In an attempt to prevent heart disease, Medicare will cover one visit a year with a primary care doctor to help lower the risk of cardiovascular disease. The doctor might discuss such things as the use of aspirin, will check blood pressure and share tips for eating well.
Depression. Medicare will cover one screening for depression a year. The test must be given in a primary care setting such as a doctor's office. Though the test is covered, the patient can expect to pay 20 percent of the Medicare-approved amount for the visit to the doctor.
Depression affects about 6 million Americans 65 and older, but only 10 percent receive treatment, according to WebMD.
"The likely reason is that the elderly often display symptoms of depression differently. Depression in the elderly is also frequently confused with the effects of multiple illnesses and the medicines used to treat them," according to WebMD.
The risk of suicide increases with depression, especially for white men. "The suicide rate in people ages 80 to 84 is more than twice that of the general population," according to WebMD. "The National Institute of Mental Health considers depression in people age 65 and older to be a major public health problem."
Obesity. About 35 percent of adults 65 and older - about 13 million people - were obese in 2007-2010, according to the National Center for Health Statistics at the federal Centers for Disease Control and Prevention. Obesity was more prevalent among people 65 to 74 than for people 75 and older, according to the report.
Medicare will pay for intensive weight-loss counseling in a setting like a doctor's office if a person's body mass index is 30 or higher. The BMI is a measure of body fat. There is a simple BMI calculator at the National Heart, Lung and Blood Institute website, http://nhlbisupport.com/bmi.
Sexually transmitted infections. "Across the nation, and especially in communities that attract a lot of older Americans, the free-love generation is continuing to enjoy an active - if not always healthy - sex life," the AARP reported on its website. "At a stage in life when many would expect sexually transmitted diseases to be waning, aging baby boomers are once again busting stereotypes, setting records and breaking rules.
The AARP quoted an analysis by the Orlando, Fla., Sentinel newspaper that used data provided by the federal Centers for Disease Control and Prevention. From 2005 to 2009, the analysis showed, "the number of reported cases of syphilis and chlamydia among those 55 and older increased 43 percent."
Medicare will cover screening for chlamydia, gonorrhea, syphillis and/or Hepatitis B once every 12 months, and each year will cover up to two, 20-to-30 minute "high-intensity behavioral counseling sessions for sexually-active adults at increased risk for STIs," according to the Medicare benefits booklet.
Also next year, Medicare recipients will pay lower percentages of the cost of name-brand and generic drugs if they reach the "donut hole," which is a gap in coverage in some policies and that varies by policy.
On the other hand, some Medicare Part D prescription drug plans are raising their monthly premiums next year. Information about policy changes and rates were announced in advance of the annual open enrollment period when changes can be made to Part D. It ends Dec. 7. That's also the deadline to make changes in Part C, which sometimes is called Medicare Advantage.
People on Medicare should have received their 2013 "Medicare & You" booklet by now from the federal Centers for Medicare and Medicaid Services. The booklet, which includes changes for all Medicare recipients, also is online in the publications section at www.medicare.gov.
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