How Senior Men Can Use Medicare to Stay Ahead of Major Health Risks
Every June, Men’s Health Month serves as a powerful reminder: prevention is the best medicine. For men over 65, staying healthy isn’t just about seeing a doctor when something feels off. It’s about using the benefits you’ve earned to stay ahead of serious health problems.
The good news? Medicare offers a wide range of preventive services, many at no cost to you, that are specifically designed to detect and manage the most common health risks men face as they age.
Let’s explore how Medicare can help you or a loved one stay healthy, independent, and informed.
Health Risks and Medicare’s Preventive Services
Heart Disease: The Leading Cause of Death for Men
According to the CDC, heart disease is the leading cause of death for men in the U.S. (it’s also the leading cause of death for women), responsible for about 1 in every 5 deaths annually. In fact, one person dies every 33 seconds from cardiovascular disease (Source: CDC).
How Medicare Helps:
Cardiovascular Disease Screenings: Cardiovascular disease screenings check for problems with your heart and blood vessels and find out if you're at risk for heart disease. Medicare covers this screening once every five years and it includes blood tests for cholesterol, lipid, and triglycerides levels to help detect conditions that may lead to a heart attack or stroke.
Cardiovascular Behavioral Therapy: Cardiovascular behavioral therapy helps lower your risk for cardiovascular disease. Medicare covers a cardiovascular behavioral therapy visit one time each year with your primary care doctor or other primary care practitioner in a primary care setting. During therapy, your doctor may discuss aspirin use, check your blood pressure, and give you tips on diet and exercise.
Obesity Behavioral Therapy: If you have a body mass index (BMI) of 30 or more, Medicare covers obesity screenings and behavioral counseling. Obesity behavioral therapy includes an initial screening for BMI and behavioral therapy sessions that include a dietary assessment and counseling to help you lose weight by focusing on diet and exercise.
Prostate Cancer: Early Detection Is Key
Prostate cancer is one of the most common cancers among men, especially those over the age of 65. Approximately 1 in 8 men will be diagnosed with prostate cancer in their lifetime, with risk increasing significantly as they age. In fact, nearly 60% of prostate cancer cases are diagnosed in men aged 65 and older (Source: Cancer.org). While many cases are slow-growing and manageable, early detection remains crucial, especially for high-risk individuals .
How Medicare Helps:
Prostate Cancer Screenings: Medicare covers digital rectal exams and prostate specific antigen (PSA) blood tests once every 12 months for men over 50 (starting the day after your 50th birthday). Enrollees pay nothing for a yearly PSA blood test (as long as they physician accepts assignment). A digital rectal exam (DRE) is also covered, but there could be out-of-pocket costs.
Diabetes: Managing the “Silent” Risk
According to the CDC, 29.2 % of U.S. adults aged 65 years or older have (diagnosed or undiagnosed) diabetes. If left unmanaged, diabetes can lead to heart disease, kidney failure, blindness, and limb loss.
How Medicare Helps:
Diabetes screenings: Medicare covers up to 2 blood glucose (blood sugar) laboratory test screenings (fasting or non-fasting) each year if your doctor determines you’re at risk for developing diabetes.
Medicare Diabetes Prevention Program (MDPP): The Medicare Diabetes Prevention Program is a health behavior change program to help you prevent type 2 diabetes. Medicare covers this program once in your lifetime, but you must meet certain criteria.
Diabetes Self-Management Training (DSMT): Diabetes self-management training may include tips for eating healthy and being active, monitoring blood glucose (blood sugar), taking prescription drugs, and reducing risks. Some patients may also be eligible for medical nutrition therapy services. If you've been diagnosed with diabetes, Medicare covers outpatient diabetes self-management training to help you manage your disease.
Ask your provider if you qualify for MDPP or DSMT. These programs are often underutilized but can significantly improve quality of life.
Mental Health: Addressing the Quiet Crisis
Mental health challenges, particularly depression and anxiety, are often overlooked in older men. Retirement, loss of loved ones, and physical health issues can all take a toll on emotional well-being.
How Medicare Helps:
Annual Depression Screening: An annual depression screening is covered at no cost during a primary care visit.
Outpatient mental health services: Outpatient mental health services involve diagnosing and treating people with mental health conditions, like depression and anxiety. They’re services you usually get outside of a hospital, such as a doctor’s or other health care provider’s office, a hospital outpatient department, or a community mental health center. Medicare covers a wide range of outpatient mental health services.
Mental health is just as important as physical health. Don't hesitate to speak to your primary care doctor or a specialist about how you're feeling, especially during life transitions
Colorectal Cancer: Preventing a Common but Avoidable Threat
Colorectal cancer is the third most common cancer diagnosed in men in the U.S. Overall, the lifetime risk of developing colorectal cancer is about 1 in 24 for men. From 2012 to 2021, incidence rates in older adults have dropped by about 1% each year which can be attributed to people getting screened and changing lifestyle-related risk factors (Source: Cancer.org).
How Medicare Helps:
Colonoscopy: Colonoscopy screening tests check for precancerous polyps (growths in the colon), cancer, and other diseases inside the rectum and colon. Medicare covers a screening colonoscopy once every 10 years (or once every 2 years if you’re at high risk), with no out-of-pocket costs if the procedure is preventive.
Stool-based tests: Medicare covers screening fecal occult blood screenings if you get a written referral from your doctor, physician assistant, nurse practitioner or clinical nurse specialist. If you’re 45 or older, Medicare covers this screening test once every 12 months. If you get a positive result after a fecal occult blood screening test, Medicare also covers a follow-up colonoscopy as a screening test.
Flexible sigmoidoscopy: Flexible sigmoidoscopy screenings examine the rectum and lower colon. Medicare covers a flexible sigmoidoscopy screening once every 48 months for most people 45 or older. If you aren’t at high risk, Medicare covers this test 120 months after a previous screening colonoscopy.
Talk to your provider about which screening method is right for you based on your health history and risk factors. Regular screening is one of the most effective ways to prevent colorectal cancer or catch it in its early stages when treatment is most successful.
Your Annual Wellness Visit: The Gateway to Prevention
The Medicare Annual Wellness Visit is your yearly opportunity to take control of your health. This is not a head-to-toe physical exam, but rather a conversation with your provider to assess risk factors, review medications, and build a preventive care plan tailored to your needs. The visit may include:
Routine measurements (like height, weight, and blood pressure)
Health advice
A review of your medical and family history
A review of your current prescriptions
Personalized health advice
Advance care planning
A screening schedule (like a checklist) for appropriate preventive services
An optional “Social Determinants of Health Risk Assessment” to help your provider understand your social needs and their impact on your treatment
A cognitive assessment to look for signs of dementia, including Alzheimer’s disease
Schedule your Annual Wellness Visit every year. It’s 100% covered under Medicare Part B when you’ve had coverage for at least 12 months.
Summary
Medicare gives men over 65 the tools to live longer, healthier lives, but only if those tools are used. Many preventive services are free or low-cost, but they’re often overlooked or misunderstood. If you’re unsure whether your current Medicare plan covers the screenings or programs you need, a licensed broker can help guide you through the options! For personalized Medicare guidance, contact Care Compass today!
Care Compass is an independent insurance agency that helps seniors navigate the complexities of Medicare and other Senior Products. Our goal is to empower Medicare-eligible individuals to make educated and informed decisions about their healthcare. Our services are offered at NO COST to you. Care Compass is proudly owned and operated in Duncansville, Pennsylvania and we serve the residents of Blair County and the surrounding region. If you need Medicare assistance near Altoona, PA, contact us today!
