Marci's Medicare Answers
I heard Medicare covers cervical cancer screenings at no cost. Is this true?—Cleo
Yes, Medicare will cover Pap smears for women with Medicare. However, they are covered differently depending on whether you are at low risk or high risk for cervical cancer. Pap smears can detect cervical or vaginal cancer in its early stages. They can also screen for sexually transmitted diseases, fibroids and various types of genital and vaginal problems, including cancer.
For women with Medicare who are considered at low risk for cervical or vaginal cancer, Original Medicare covers 100 percent of the cost of one Pap smear every two years (24 months). Medicare Advantage (MA) plans must cover cervical cancer screenings in the same way that Original Medicare does if you see an in-network provider.
For women who are of childbearing age and who have had an abnormal Pap smear in the past 36 months, Medicare covers 100 percent of the cost of one Pap smear every year (every 12 months). Medicare will also cover a Pap smear once a year for women who are considered at high risk of developing cervical or vaginal cancer. Women are considered at high-risk for cervical or vaginal cancer if:
- They were active sexually early (under 16 years of age)
- They have had multiple sexual partners (five or more)
- They have had a sexually transmitted disease
- Their mother was given the drug diethylstilbestrol (DES) during pregnancy
- They smoke
- They have received fewer than three negative Pap tests or no Pap test in the past seven years
- They have used birth control pills for an extended period of time (five years or more)Marci
I enrolled into a new Medicare Advantage plan during Fall Open Enrollment, but I don't like it. Can I switch out of this plan?—Dorian
Yes, you can switch from your Medicare Advantage (MA) plan to Original Medicare during the Medicare Advantage Disenrollment Period (MADP). You can only make this coverage change if you have a Medicare Advantage (MA) plan, and you can only switch into Original Medicare. You cannot switch from one MA plan to another. The MADP occurs every year from January 1 to February 14.
If you have a Medicare Advantage plan you will be able to switch to Original Medicare with or without a stand-alone prescription drug plan. Changes made during this period will become effective the first of the following month. For example, if you switched from a Medicare Advantage plan to Original Medicare and a stand-alone prescription drug plan in February, your new coverage would begin March 1.
Remember, if you are enrolled in a Private-Fee-For-Service (PFFS) plan with a stand-alone drug plan, you must keep your stand-alone prescription drug plan if you switch to Original Medicare during the MADP.Marci
I have Medicaid and a Medicare Part D plan. How do Medicare and Medicaid coordinate to cover my drug costs?—Cato
If you have Medicare and Medicaid, you will usually get your drugs covered by the Medicare prescription drug benefit (Part D) and the Extra Help program. Extra Help is the federal program that pays for most of the costs of Medicare drug coverage. In limited cases, Medicaid may cover drugs that Medicare does not cover.
For example, in many states, Medicaid covers some drugs that are excluded from Medicare coverage by law. Drugs excluded from Medicare coverage by law that may be covered by your state’s Medicaid program include:
- Certain anti-anxiety drugs (barbiturates and benzodiazepines)
- Drugs for:
- Anorexia, weight loss or weight gain
- Cosmetic purposes or hair growth
- Relief of cold symptoms, like a cough and stuffy nose
- Prescription vitamins and minerals (except prenatal vitamins and fluoride preparations, which are covered by Medicare)
- Non-prescription drugs (over-the-counter drugs)
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Marci’s Medicare Answers is a service of the Medicare Rights Center (www.medicarerights.org), the nation’s largest independent source of information and assistance for people with Medicare. To subscribe to “Dear Marci,” MRC’s free educational e-newsletter, click here.
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