Table 1.

United States Preventive Services Task Force (USPSTF) Recommended Services and Medicare Coverage for Prevention in Adults 65 Years of Age and Older

ServiceRatingDetailsPreventive Coordination: Risk Assessment, Patient Motivation, and Arranging the ServicePreventive Service: Test, Screening Instrument, or Counseling
Partially reproduced and reprinted with permission from: Lesser LI, Bazemore AW. Improving the delivery of preventive services to Medicare beneficiaries. JAMA. 2009;302(24):2699–2700.
BMD = bone mineral density; Pap = Papanicolaou; WMV = Welcome to Medicare Visit.
aFor services where the USPSTF including screening and counseling in the same recommendation, the screening portion was considered as “risk assessment and arrangement.”
bColonoscopy would be fully covered, as, if normal, would only need one-time screen. Sigmoidoscopy and fecal occult blood testing would not be, as repeated screenings would be needed.
Abdominal aortic aneurysm (screening)BOne-time ultrasound for men ≥65 y who have ever smokedFullyFully
Alcohol (screening and counseling)aBScreen and counsel all adultsPartial: WMV onlyFully
Breast cancer, genetic risk assessment (screening)BReferral for genetic counseling with option for testing for women with a family history suggestive of breast cancer mutationFullyNone
Breast cancer, mammographyBScreen all women, ages 50–74 y, every 2 yPartial: WMV onlyFully
Cervical cancer, at increased riskAScreen all women who have been sexually active and have a cervix. Recommends against screening women >65 y if they have had adequate recent screening with normal Pap smears and are at otherwise not at high riskPartial: WMV onlyFully
Colon cancer ages 50–75 yAScreen with fecal occult blood testing, sigmoidoscopy, or colonoscopy, from the ages of 50 to 75 yPartial: WMV onlybFully
Depression (screening)BScreen adults for depression, when care supports are availablePartial: WMV onlyPartial: WMV only
Diabetes, if at riskBScreen adults with sustained blood pressure (either treated or untreated) >135/80 mm HgPartial: WMV onlyFully
Healthy diet, if at risk (counseling)BIntensive counseling (usually multiple sessions lasting 30 min or more) for adults with risks for cardiovascular or diet-related chronic diseasePartial: WMV onlyPartial: inconsistent indication
High blood pressureACheck the blood pressure of all adultsPartial: WMV only
 Partial: inconsistent indicationPartial: WMV only
Lipid disorders, men >35 yAScreen all, with an uncertain, but likely interval of every 5 y. Repeated screening less likely of benefit in those >65 yPartial: WMV onlyFully
Lipid disorders, women >45 y at increased riskAScreen all, with an uncertain, but likely interval of every 5 y. Repeated screening less likely of benefit in those >65 yPartial: WMV onlyFully
Obesity (screening with intensive counseling)aBScreen all adults and offer high-intensity counseling for obese adultsPartial: WMV onlyPartial: inconsistent indication
Osteoporosis, women at riskBScreen all women >65 y. Interval uncertain, but yield of repeated screening will be higher in older women, those with lower BMD at baseline, and those with other risk factors for fracturePartial: WMV onlyFully
Tobacco useAAsk all adults about tobacco use and provide tobacco cessation interventions for those who use tobacco productsPartial: WMV onlyFully