Medicare Pays - Get the Most from It! (cont.)

3. Flu shot

  • Eligible patients: Medicare beneficiaries
  • When Needed: Medicare will pay for the flu shot once every flu season. In some cases this may mean twice in one year. For example, if you received a shot in January 2005 for one flu season, you could be inoculated again in October 2005 for another flu season.
  • Cost: Free if your doctor or provider accepts Medicare. Medicare will pay about $18 for your flu shot if you go to a doctor or provider who doesn't participate in Medicare. This amount varies by State and could be less than a doctor or provider charges you.

4. Pneumonia shot

  • Eligible patients: Medicare beneficiaries
  • When needed: Once for some patients, more than once for others
  • Cost: Free

5. Hepatitis B shot

  • Eligible patients: Medicare beneficiaries at high or medium risk for hepatitis B
  • When needed: Three shots are needed for complete protection. Check with your doctor about when to get these shots if you qualify to get them.
  • Cost: 20 percent of Medicare-approved amount after yearly Part B deductible
  • At risk for Hepatitis B: These common factors put you at medium to high risk for hepatitis B: hemophilia, end-stage renal disease, a condition that lowers your resistance to infection. Check with your doctor if you are unsure as to your risk.

6. Mammogram to screen for breast cancer

  • Eligible patients: Female Medicare beneficiaries age 40 and older. Medicare also pays for one baseline mammogram for women with Medicare between the ages of 35 and 39.
  • When needed: Once a year
  • Cost: 20 percent of Medicare-approved total (no Part B deductible)

7. Pap smear and pelvic exam to screen for cervical cancer

  • Eligible patients: female Medicare beneficiaries
  • When needed: Once every 24 months (2 years). However, if you are of childbearing age and have had an abnormal Pap test within the past 36 months, or if you are at high risk for cervical or vaginal cancer, Medicare will cover a Pap test and pelvic exam every 12 months.
  • Cost: Pap smear lab test free (no co-pay, no Part B deductible); Pap test collection and pelvic exam, 20 percent of Medicare-approved total (no Part B deductible)

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