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News Release

Tuesday, Nov. 9, 2004

CMS Public Affairs
(202) 690-6145

Medicare Preventive Benefits Begin January 2005 With A Goal of Healthier Seniors

America's seniors will soon have new benefits that will help them live healthier lives, including Medicare-provided medical screenings for heart disease and diabetes, HHS Secretary Tommy G. Thompson announced today in an department-wide campaign to maximize preventative health care.

For new Medicare beneficiaries, the "Welcome to Medicare" physical exam, coupled with an increasingly broad set of preventive benefits including prescription drug coverage, provides Medicare beneficiaries with greater access to more prevention-focused benefits than ever before. These services are key features of the Medicare Modernization Act (MMA), signed into law by President George W. Bush in December 2003.

To support the focus on prevention-oriented health care for seniors, Secretary Thompson launched a coordination of resources between HHS agencies, specifically the Centers for Medicare & Medicaid Services (CMS) and the Centers for Disease Control and Prevention (CDC).

"We are committed to healthy aging and to closing the prevention gap so America's seniors can learn new ways to prevent illness and if they do get sick, to treat problems early," Secretary Thompson said. "This new effort will improve the quality of life for seniors and their families."

Medicare recently mailed an updated "Medicare and You" handbook that, for the first time, emphasizes Medicare's new prevention-oriented focus. The handbook informs beneficiaries of what they should do to take advantage of these new services dedicated to early detection and treatment of disease.

"Too many seniors do not use the services that make it possible to find and treat illnesses before they lead to more serious problems, as well as avoidable increases in health care costs," said CMS Administrator Mark B. McClellan, M.D., Ph.D. "The new law gives us the tools to close this 'prevention gap' for seniors, and we're going to do all we can to use these new opportunities to keep seniors healthy."

The difference between the number of seniors who could take advantage of preventive services that include vaccines and screenings and those who actually do is known as the "prevention gap."

CMS will also work closely with the CDC and other HHS agencies to share the prevention message with seniors and their families throughout the nation to broaden the emphasis on prevention and early detection, including the areas of diabetes, elevated cholesterol levels and cancer.

"This new Medicare screening exam will go a long way to help protect our seniors' health and thus help them achieve their full life expectancy," said CDC Director Julie Gerberding, M.D., M.P.H. "It will also provide an opportunity to educate our seniors of the importance of choosing health by eating a diet rich in fruits and vegetables, engaging in regular physical activity and not smoking -- all things that can help prevent chronic diseases which rob so many people of their health."

Medicare's new comprehensive set of preventive benefits includes the "Welcome to Medicare" physical exam and screening for heart disease and diabetes. Coverage also includes screening for weak bones, glaucoma, and cancers of the colon, breast, cervix, and prostate.

The exam is aimed at providing education and counseling about the preventive services that may be needed. Dr. McClellan said he believes the exam will significantly improve the health prospects of Medicare beneficiaries as they enter the program and learn about preventive measure they may not have known were needed.

Closing the prevention gap, Dr. McClellan noted, could save many thousands of lives and billions of dollars in avoidable medical expenses for preventable complications associated with heart disease, diabetes, cancer, weak bones, high blood pressure, smoking, inactive lifestyles, and other illnesses and unhealthy behaviors.

"Medicare's coverage and Medicare's expenses have historically focused on paying to treat costly health problems after they occur," said Dr. McClellan. "With Medicare's new support to help seniors use recommended preventive care and prescription drugs to avoid these costly and debilitating problems, that's going to change."

Dr. McClellan also noted that Medicare Advantage (MA) plans have the flexibility to cover far-reaching prevention services, such as wellness programs, beyond what Medicare covers. MA plans offer prevention benefits including health education services, exercise programs and other services that not only alert patients to potential health risks, but also actually work with them to change harmful lifestyles and encourage healthy behavioral changes.


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Last Revised: November 9, 2004

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