Why Medicare Can Be Different for Women

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Medicare is a federal health insurance program that began in 1965. Hospital and medical coverage offered by Medicare is through Part A and Part B, respectively. These benefits are the same for every Medicare beneficiary, but the Medicare premiums depend on several factors, including work history and income.

Since Medicare does not cover all hospital and medical costs, many beneficiaries will enroll in a Medicare Supplement plan or Medicare Advantage plan to help with those out-of-pocket costs. The coverage you get from your plan will be the same, no matter if you are a man or a woman. However, gender is one factor that can determine your Medicare Supplement premium. Women usually have a lower monthly premium with carriers that take gender into account.

When it comes to coverage, Medicare does cover certain preventive and medical services for women.

Preventive services for women

Medicare covers several preventative services for women, and since they are preventative, you should not pay anything for these services. One of those services is mammograms. Medicare covers a standard mammogram once every 12 months. If you need a diagnostic mammogram, Medicare can cover it more frequently, but the Part B deductible and coinsurance apply to the procedure.

Medicare also covers pelvic exams and pap smears for women. You can get a pelvic exam and pap smear once every 24 months, but it can cover them more frequently if you are at high risk for cervical or vaginal cancer.

According to the American Cancer Society, about 20% of cervical cancer cases are in women 65 and older, while about 1 in 8 women develop breast cancer at some point in their life. These preventative services that Medicare covers can help detect the early stages of cancer and should be taken advantage of.

Medical services for women

The Centers for Disease Control and Prevention stated that 18.4% of adults ages 65 and older suffer from depression, and women are more likely to have symptoms of depression. If your provider offers the Psychiatric Collaborative Care Model, Medicare can pay your provider to help you with depression or anxiety. The care model includes a care plan, ongoing assessments, medication support, and more. Since women are more likely to show symptoms, this specific service may benefit those with depression.

Osteoporosis and women

Another health condition that can affect women more than men is osteoporosis. The National Osteoporosis Foundation has estimated about 80% of the 10 million Americans with osteoporosis are women. It is also essential to know that one in two women will break a bone because of this health condition. A woman’s body tends to have smaller and thinner bones than men, making them more prone to osteoporosis and breaks. Menopause can also cause bone loss because estrogen decreases when women reach this phase in life.

Medicare Part B can cover osteoporosis injections if you meet the following requirements:

  • You’re a woman.
  • You meet Medicare’s home health services criteria, and you have Part B.
  • You have a bone fracture due to related postmenopausal osteoporosis.
  • Your doctors certify that you cannot give yourself the injection and other family members are unable or unwilling.

If Medicare Part B does cover this injection, then the Part B deductible will apply, and you will be responsible for the 20% coinsurance. However, a Medigap plan, such as Plan G, will help cover the 20% coinsurance.

Conclusion

Original Medicare coverage and Medigap and Medicare Advantage will be the same for every beneficiary. However, there are certain preventive and medical services specific to women. The right plan for you will depend on your medical needs, budget, and lifestyle, so you will want to evaluate your situation and research plans and benefits to know what will be most cost-effective.

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