Marci's Medicare AnswersFebruary 2010
Dear Marci,
I’m at risk for osteoporosis. Does Medicare cover bone density tests?
—ShirleyDear Shirley,
Yes. If your doctor believes you are at risk for osteoporosis and orders the test, Medicare will cover 80 percent of the cost of one bone mass measurement (sometimes called "bone density tests") every two years (24 months), after you pay your annual Part B deductible. Medicare will also cover follow-up measurements or more frequent screening if your doctor prescribes them.
Bone mass measurements show if you need medical treatment for osteoporosis, a condition that causes "brittle bones" in many older adults. Those at high risk for the disease include people who have a family history of the disease, have spinal abnormalities, have certain conditions (such as thyroid disorders) or have taken certain medications for a prolonged period of time (such as a steroid anti-inflammatory).
—MarciDear Marci,
I turned 65 last month, but I’m still working and have employer insurance. Should I enroll in Medicare Part B?
—WilburDear Wilbur,
It depends on your situation. In general, if Medicare is your primary coverage, you should enroll in Part B. If you are 65 or older and there are fewer than 20 employees in the company you or your spouse works for, Medicare is your primary coverage. If you have not yet enrolled in Part B, you should enroll during your Initial Enrollment Period. If you decline Part B, neither Medicare nor your job coverage (with limited exceptions) will pay for your doctors' services and other medical care.
If you are 65 or older and there are 20 or more employees in the company you or your spouse works for, your employer group health plan is your primary insurer. You do not need to enroll in Medicare if you are satisfied with your job coverage.
In either case, you qualify for a Special Enrollment Period, which means you can delay enrollment in Part B without penalty if you were covered by employer health insurance through your or your spouse’s current job when you first became eligible for Medicare. You can enroll in Medicare without penalty at any time while you have group health coverage and for eight months after you lose your group health coverage or you (or your spouse) stop working, whichever comes first.
—MarciDear Marci,
I’ve heard that something called an SPAP can help me pay for my prescription drugs. What is an SPAP, and how does it work?
—HansDear Hans,
Many states offer a state pharmaceutical assistance program (SPAP) to help their residents pay for prescription drugs. Each program works differently, but many states coordinate their drug assistance programs with Medicare’s drug benefit (Part D). If you do not have Part D but qualify for your state’s SPAP, you will have the chance to sign up for Part D, and may be required to enroll in a Part D plan. Your SPAP may help pay for your Part D plan’s:
- premium;
- deductible;
- copayments; and/or
- coverage gap. (Many SPAPs give you coverage during your part D plan’s “coverage gap” or “doughnut hole.”)
To find out more information about SPAPs in your state, visit www.medicareinteractive.org.
—MarciMarci’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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