April 27, 2016
By Tom Canty, Vice President and General Manager, Empire BlueCross BlueShield Government, Labor and Special Account
Shortly after infants are born they receive their first health screening. This is the first of a lifetime of screenings, continuing well into adulthood. What many people don’t realize is that there is a schedule for the types of screenings they should get and when they should get them and that it’s important to stick to that schedule to maintain optimal health, particularly as we age.
While a doctor can provide a list of specific recommendations, some of the more important screenings for older adults have costs that may be covered by a Medicare or Medicare Advantage (MA) plan. These include the following:
Diabetes screening. More than one-fourth of people age 65 and older have diabetes.i It is one of the top causes of death for older adults. Diabetes can be detected by one of a number of blood tests. Testing should begin at age 45 and continue every three years.ii People with pre-diabetes can often reduce their risk of diabetes with weight loss and increased physical activity. Drug therapy may also be prescribed. Anyone who progresses to diabetes may be prescribed medication and should have regular blood tests as well as eye and foot exams.
Body Mass Index (BMI) screening. Having a BMI of more than 30 percent is considered to be obese. Obesity contributes to a host of chronic diseases.iii That’s why it’s important to have a BMI screening at least once a year. This can be done either electronically or through a calculation of height and weight. A qualified physician can help develop an appropriate diet and exercise plan for those diagnosed as obese.
Colorectal screening. Colon cancer is the second leading cause of cancer-related deaths in the United States.iv Screening for colon cancer should begin no later than age 50 and continue every five years until age 75.v There are several different screening options. Screening can find precancerous polyps and remove them before they turn into cancer or catch cancer at an early stage when treatment often leads to a cure. Early detection of colorectal cancer is the top reason for a recent decrease in deaths from this disease.
Osteoporosis screening. Osteoporosis is a disease that causes bones to become weak and break easily. Anyone can get osteoporosis, but it is most common in women. As a result, women should be screened for osteoporosis beginning no later than age 65.vi There are a number of imaging tests to help detect the disease. People with osteoporosis may be prescribed medication and encouraged to make lifestyle changes.
Hypertension (high blood pressure) screening. Hypertension can lead to heart attack, stroke, heart failure, renal failure and even death if not treated. Screening is done with a blood pressure cuff. Blood pressure screening should be taken at least annually, beginning at age 45.vii People with hypertension will likely be prescribed medication and encouraged to make lifestyle changes, including adopting a healthy diet and exercising.
Lipids (cholesterol) screening. Heart attack and stroke are usually caused by atherosclerotic cardiovascular disease (ASCVD), which develops because of a build-up of cholesterol-rich plaque.viii Levels are measured with a blood test, which should be administered at least once every five years. Treatment generally starts with a drug called a statin, along with lifestyle changes, including diet and exercise.
Falls prevention screening. One in three older adults fall each yearix, resulting in hip fractures, traumatic brain injuries or even death. To prevent this, doctors assess older adults for their risk of a fall, including reviewing medications and checking vision and balance. Those at risk of falling should take measures to make their homes safer.
By getting these screenings, and others, diseases and other health conditions can be detected early before they worsen. Many conditions can be treated successfully by maintenance medication that may be covered in all or in part by a person’s Medicare Part D plan. Additionally, most MA plans provide other benefits, such as free fitness programs or smoking cessation products, to help promote healthy lifestyles.
ii Diabetes Care Volume 37, Supplement 1, January 2014
iii NHLBI Obesity Education Initiative Expert Panel on the Identification, Evaluation, and Treatment of Obesity in Adults (US). Bethesda (MD): National Heart, Lung, and Blood Institute; 1998 Sep.
vii 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults Report from the Panel Members Appointed to the Eighth Joint National Committee (JNC 8)
viii 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults