Still Crazy After All These Years: Preventive Services and Healthy Aging

by Ron Pollack

(Editor's Note: Ron Pollack is the executive director of Families USA, the national organization for health care consumers.)
A fun-loving, active couple I know, both of whom are older than 85, recently performed in an hour-long musical production. And they were pretty darn good! They are clearly in love and enjoying life. What are they doing right? They told me that they "take care of themselves." Nothing magical, and no miracle treatments have extended their golden years.
Both these friends eat healthily, exercise, and see a doctor regularly to catch problems early. Both have had colon cancer, which was detected early and treated successfully. Both take medication for their high blood pressure. One of them is managing diabetes. Both go to the doctor once a year — even if they feel great — to get "some basic tests."
The way they take care of themselves mirrors a key public health strategy: Getting appropriate screenings and regular check-ups, which can prevent disease or detect disease early when treatment is more effective. These services include screenings for chronic conditions, immunizations, and counseling about personal behaviors like eating habits.
Despite the fact that preventive services can save lives, only 25 percent of adults aged 50 to 64 are up-to-date on getting preventive services, and less than 50 percent of adults aged 65 years and older are up-to-date on these services.
Fortunately, the Affordable Care Act makes getting preventive services easier — and easier to afford. Private insurance and Medicare must cover all preventive services that are recommended by the United States Preventive Services Task Force for free. These services include:

  • age-appropriate immunizations
  • screenings for high blood pressure and cholesterol;
  • screenings for colon, breast, and prostate cancer;
  • bone mass testing for osteoporosis; and
  • screening for diabetes.

And Medicare now provides a free "Welcome to Medicare Exam." This is an initial physical exam you can get within the first year of signing up for Medicare Part B (which covers doctor and other outpatient care). This exam looks at your current health status, identifies risk factors, reviews your medications, and sets reasonable goals for improving your health. This visit also looks for weight, hearing, and vision issues, which are critical for older patients.
In addition, Medicare provides an annual, free "Wellness Exam," which includes many of the same tests as the Welcome to Medicare Exam. During these exams, you and your doctor have the opportunity to work together over the long term to achieve health and wellness goals.
We all want to have a long, healthy life. What are the "secrets" of living to an advanced age? Research gives us some clues that reinforce the common sense of the friends I mentioned earlier. A large-scale study found that five key factors make a tremendous difference in longevity and quality of life: 

  1. not smoking
  2. maintaining a healthy weight
  3. keeping blood pressure under control
  4. controlling diabetes
  5. staying physically active

An older person who scores well on these key factors has a 10 times greater chance of reaching 90 and being healthier. The regular wellness visits and screening and preventive services that are now available and affordable under the Affordable Care Act are key to putting you on the path to a long, healthy life.
Of course, if you do get sick, Medicare covers your doctor and hospital bills the same as it always has. Make sure you understand what Medicare covers and what it doesn't and how Medicare works with any other coverage you have (like a Medigap policy, coverage from a former employer, or Medicaid). If you have questions, call 1-800-MEDICARE. You can ask for the name and number of your local State Health Insurance Assistance Program, which offers free insurance counseling to everyone with Medicare.
(A couple of important notes about costs: While you do not have to pay for many preventive services, you may have to pay for a doctor visit if you receive additional services while you are there. Also, if you need to have more frequent screenings, you may have to pay for those screenings. And if you receive your preventive services in an ambulatory surgical center or a hospital's outpatient department rather than at your doctor's office, you may have to pay for those services.)