Greg Dill: How Medicare deals with osteoporosis
May 17, 2018
Brittle bones could shatter your life.
Every year, more Americans are diagnosed with osteoporosis, a disease that causes bones to weaken and become more likely to break. You may not know you have this "silent" disease until your bones are so weak a sudden strain, bump, or fall causes your wrist to break or your hip to fracture.
Medicare can help you prevent or detect osteoporosis at an early stage, when treatment works best.
Talk to your doctor about getting a bone mass measurement. If you're at risk, Medicare Part B covers this test once every 24 months (more often if medically necessary) when your doctor or other qualified provider orders it.
A bone mass measurement test helps to see whether you have osteoporosis or should be concerned about your bones. Some people call this test a bone mineral density (BMD) test.
A BMD test uses a special machine to measure the amount of bone mineral you have in a certain area of bone. Bone density testing can be done on different bones of your body, including your hip, spine, forearm (between the wrist and elbow), wrist, finger or heel.
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A BMD test is safe and painless, and it provides important information about your bone health. Your healthcare provider uses this information to make recommendations to help you protect your bones.
If you're diagnosed with osteoporosis, your healthcare provider may order laboratory and other tests. These tests can help your healthcare provider find out if you have another medical condition causing bone loss.
Who's eligible for the bone test? All qualified people with Part B who are at risk for osteoporosis and meet one or more of these conditions:
A woman whose doctor determines she's both estrogen deficient and at risk for osteoporosis;
A person whose X-rays show possible osteoporosis, osteopenia, or vertebral fractures;
A person taking prednisone or steroid-type drugs or is planning to begin this treatment;
A person who has been diagnosed with primary hyperparathyroidism;
A person who's being monitored to see if their osteoporosis drug therapy is working.
You pay nothing for a bone density test if your doctor or other qualified health care provider accepts Medicare payment rates for his or her services and agrees not to bill you for anything other than the Medicare deductible or coinsurance.
Osteoporosis and the broken bones it can cause aren't part of normal aging. And there's a lot you can do to protect your bones throughout your life.
You're never too young or too old to improve the health of your bones. Osteoporosis prevention should begin in childhood. But it shouldn't stop there. Whatever your age, the habits you adopt now can affect your bone health for the rest of your life. Now is the time to take action.
What can you do to protect your bones?
Get enough calcium and Vitamin D and eat a well-balanced diet.
Engage in regular exercise.
Eat foods that are good for bone health, such as fruits and vegetables.
Avoid smoking and limit alcohol to 2-3 drinks per day.
Medicare defines medically necessary services and supplies as those needed to diagnose or treat an illness, injury, condition, disease, or its symptoms and that meet accepted standards of medical care.
Your doctor or other health care provider may recommend you get services more often than Medicare covers. Or they may recommend services Medicare doesn't cover. If this happens, you may have to pay some or all of the costs.
Ask questions so you understand why your doctor is recommending certain services and whether Medicare will pay for them.
Here's a short video so you can learn more about how Medicare can help you protect your bones: https://www.youtube.com/watch?v=kw81xi_njN4
Greg Dill is Medicare's regional administrator for Arizona, California, Hawaii, Nevada, and the Pacific Territories. You can get answers to your Medicare questions by calling 1-800-MEDICARE (1-800-633-4227).