NCI Cancer Bulletin: A Trusted Source for Cancer Research NewsNCI Cancer Bulletin: A Trusted Source for Cancer Research News
January 25, 2005 • Volume 2 / Number 4 E-Mail This Document  |  Download PDF  |  Bulletin Archive/Search  |  Subscribe

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New Medicare Prevention Benefit Guides Seniors
to Cancer Screenings


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The beginning of the new year offers some welcome news for new Medicare beneficiaries: coverage for a comprehensive physical that includes appropriate referrals for cancer screenings. As of Jan. 1, 2005, all new Medicare enrollees are eligible for a "Welcome to Medicare" check-up that includes referral for important prevention measures already covered by Medicare, including colorectal, prostate, ovarian, and breast cancer screening.

"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 Dr. Mark B. McClellan, administrator of the Centers for Medicare and Medicaid Services (CMS), which operates the Medicare program. Coverage of the "Welcome to Medicare" check-up was included in Medicare modernization legislation enacted in December 2003. "The new law gives us the tools to close this 'prevention gap' for seniors," added Dr. McClellan, "and we're going to do all we can to use these new opportunities to keep seniors healthy."

Cancer is the leading cause of death for Americans between the ages of 60 and 79. Last year, more than 2 million Medicare beneficiaries were actively treated for cancer and cancer was the cause of death for 390,000 beneficiaries. Increasing the number of elderly patients who undergo recommended cancer screenings, says Dr. Mark Clanton, NCI deputy director for cancer care delivery systems, should help ensure that more Medicare beneficiaries' cancers are detected earlier than they otherwise might have been.

"In the case of the new benefit, Medicare beneficiaries will be directed to the appropriate screenings by their physician," said Dr. Clanton. "That's extremely important, because a doctor's recommendation is perhaps the strongest determinant of whether a patient will undergo screening."

In addition to guidance about covered cardiovascular and diabetes tests and screening, physicians conducting "Welcome to Medicare" check-ups will also advise patients about nutritional counseling and smoking cessation services covered by Medicare. Later this year, some Medicare beneficiaries will be eligible for coverage of additional smoking-cessation counseling. The proposed coverage, which was announced on December 23 and was open for public comment until January 23, will include beneficiaries who have an illness caused or complicated by smoking, such as heart or lung disease, as well as those who take any medications whose effectiveness is complicated by smoking.

"The combination of lives lost unnecessarily and the cost of treating smoking-related diseases makes our investment in smoking cessation benefits all that more important," said outgoing HHS Secretary Tommy Thompson. "It's never too late to benefit from quitting smoking."

For additional information about the "Welcome to Medicare" check-up, go to: http://www.medicare.gov/health/physicalexam.asp