How Medicare covers preventive healthcare

SAVVY SENIOR

By Jim Miller

Dear Savvy Senior,

How does Medicare cover preventive health screenings? I’m due to get a physical and a colonoscopy this year, but I want to find out what I’ll have to pay for before I go in.

Just Turned 65

Dear Just Turned,

You’ll be happy to know that Medicare covers a wide array of preventive and screening services to help you stay healthy, but not all services are completely covered.

Most of Medicare’s preventive services are available to all beneficiaries (through Part B) completely free with no co-pays or deductibles, as long as you meet basic eligibility standards. Mammograms; colonoscopies; shots against flu, pneumonia, COVID-19 and hepatitis B; screenings for diabetes, depression, osteoporosis, HIV, various cancers and cardiovascular disease; and counseling to combat obesity, alcohol abuse, and smoking are just some of Medicare’s covered services. But to get these services for free, you need to go to a doctor who accepts Medicare “on assignment,” which means he or she has agreed to accept the Medicare approved rate as full payment. Also, the tests are free only if they’re used at specified intervals. For example, cardiovascular screening blood tests once every five years; or colonoscopy once every 10 years or every two years if you’re at high risk.

Medicare also offers a free “Welcome to Medicare” exam with your doctor in your first year, along with annual “Wellness” visits thereafter. But don’t confuse these with full physical exams. These are prevention-focused visits that provide only an overview of your health and medical risk factors and serve as a baseline for future care. 

Cost-sharing

There are a few Medicare preventive services that require some out-of-pocket cost-sharing. You’ll have to pay 20 percent of the cost of the service after you’ve met your $226 Part B yearly deductible. The services that fall under this category include glaucoma tests, diabetes self-management trainings, barium enemas to detect colon cancer, and digital rectal exams to detect prostate cancer. For a complete list of services along with their eligibility requirements, visit Medicare.gov/coverage/preventive-screening-services.

If you’re enrolled in a Medicare Advantage (Part C) plan, your plan is also required to cover the same preventive services as original Medicare as long as you see in-network providers.

You also need to know that while most of the previously listed Medicare services are free, you can be charged for certain diagnostic services or additional tests or procedures related to the preventive service. For example, if your doctor finds and removes a polyp during your preventive care colonoscopy screening, you will pay 15 percent of the doctor’s service fee. Or, if during your annual wellness visit, your doctor needs to investigate or treat a new or existing problem, you’ll probably be charged. You may also have to pay a facility fee depending on where you receive the service. Certain hospitals, for example, will often charge separate facilities fees when you’re receiving a preventive service. And you can also be charged for a doctor’s visit if you meet with a physician before or after the service.

To eliminate billing surprises, talk to your doctor before any preventive service procedure to find out if you may be subject to a charge, and what it would be.  

Jim Miller is a contributor to NBC TV’s “Today.” Send senior questions for him to Savvy Senior, P.O. Box 5443, Norman, OK 73070, or at savvysenior.org.

Three shots at not getting sick

The national Centers for Disease Control (CDC) recommends getting vaccinated against flu by October and getting the latest anti-COVID shot. And for the first time, vaccines are available for RSV – another anticipated virus to contend with this year.

To help make that happen locally, information on where and how to get a flu shot and other vaccinations is available from the Tacoma-Pierce County Health Department (tpchd.org, 253-649-1500), Seattle-King County Public Health (kingcountywa.gov, 206-296-4774), the Washington Department of Health (doh.wa.gov, 800-525-0127), and vaccines.gov,a CDC-hosted website.

Here’s what else to know:

Flu.

Anyone can get sick with flu, some worse than others. People with the highest risk of severe illness include those 65 and older, children younger than 5, and pregnant women. Adults with asthma, heart disease, diabetes, and chronic kidney disease also are high-risk. Medical experts say a flu shot is the best way to avoid getting the fever, cough, sore throat, and achiness that comes with the bug. The CDC and other health authorities note the potential spread of flu will likely increase in October, peak between December and January, and continue into next May. And while getting a shot early in the flu season is best, it’s not too late to do it later in the season.

RSV.

Respiratory syncytial virus, or RSV, is a common virus that affects lungs and makes breathing difficult. It’s more common in the spring and fall. While people of all ages can get it, the virus is worse for children under 5 years old and older adults, especially ones in poor health. The CDC has reported that RSV causes approximately 160,000 hospitalizations and 10,000 deaths among adults 60 and older every year, and the agency recommends that older adults receive the RSV vaccination.

COVID.

A new CDC-recommended COVID-19 vaccine is expected to be widely available this fall. One dose of the 2023-24 Moderna or Pfizer vaccines are urged for virtually all ages, starting at 6 months old. An alternative vaccine, Novavax, is offered for anyone unable or unwilling to go with Moderna or Pfizer. While hospitalizations and deaths due to COVID-19 are low compared to the height of the pandemic, the virus still exists and could, like other viruses, spread this fall and winter as people spend more time indoors with others. Most people can be vaccinated for free, and if there is a cost, consumers with health insurance can have it covered through their plans.

Private medical and healthcare providers, plus pharmacies such as CVS, provide vaccinations.

Influenza claims lives annually. The 2022-23 flu season ended with 261 deaths statewide attributed to flu, according to the state Department of Health. Of those, 35 were reported in Pierce County and 57 in King County.

How the fair got here

By Paula Becker

On Oct. 4-6, 1900, a group of Puyallup Valley farmers, business people, and other residents join together to produce an agricultural and livestock fair designed to highlight local products. The event is called the Valley Fair and is so successful that it becomes an annual event. In time it will become the Western Washington Fair Association’s Puyallup Fair (since renamed the Washington State Fair) and draw the fifth-highest attendance of any fair in the country.

The main promoter of the Valley Fair was Lewis Alden Chamberlain, a farmer from Buckley who successfully mounted a similar agricultural event in Enumclaw in 1899.

Alden set about convincing farmers in the Puyallup-Sumner Valley that their location would make it easy to draw crowds from as far away as Seattle and Tacoma. Chamberlain approached the Puyallup Board of Trade with his idea. The board gave the project their support, and in June of 1900 some of the valley’s most progressive farmers organized the Valley Fair Association. Chamberlain was elected president of the newly formed association. William Hall Paulhamus became vice president, James P. Nevins secretary, and George D. Spurr treasurer.

Board members circulated through the valley offering $1 shares of 1,000 possible shares of capital stock they had issued to fund the fair to merchants, farmers, and anyone else they could corral. Although only $82 was raised through stock sales, and some of that was the value of trade labor rather than cash, board members pushed ahead with preparations, erecting a 10-foot fence around a vacant lot west of Puyallup’s Pioneer Park.

As they busily set up a borrowed tent within the fence on the evening before the planned Oct. 4 opening, gusts of wind collapsed it. It took until after midnight to re-pitch the tent and repair the damage.

The Valley Fair board, however, had evidently not managed to stir up sufficient local enthusiasm. When the gate opened, no exhibitors had yet materialized. Vice president Paulhaumus recalled events in a newspaper report in 1920: “Chamberlain stood at the gate most of Thursday morning without any exhibits being turned in. About noon, Romulous Nix was seen coming down the dusty road leading a shorthorn bull, unknown breeding. [Nix’s name was actually Rhonymous or Ronimous. Apparently he used both spellings but usually abbreviated it and used the name R. Nix.] Mr. Chamberlain gave his old friend a warm greeting and found a fencepost to which the Nix bull could be tied. The bull had some qualifications besides being the head of the herd. He had also been taught to permit boys to ride on his back, and instead of having a merry-go-round or a Ferris wheel, the children were entertained by taking a ride on the back of the Nix bull.”

Paulhaumus arrived soon thereafter with a heard of Jersey cows, some calves, a wagonload of chickens, ducks, and geese, and some Berkshire hogs. With the Nix bull, they constituted the fair’s initial livestock exhibit. By the time the event concluded, several horses and foals and an owl had joined the exhibition.

Examples of the Puyallup-Sumner Valley’s bounteous produce were on display inside a tent, as were various kinds of needlework, baked items, and jams and jellies. Contestants vied for prizes in categories such as best raspberry wine, most butter made in 24 hours, and best example of Hubbard squash. A pair of slippers was promised to the child under age 16 who produced the best essay on Puyallup Valley history. A number of valley merchants also displayed their wares.

A $1 admission fee covered an entire family for the entire run of the fair, and also gave that family one vote in the election of fair officers for the next season. Newspaper writers were admitted free of charge.

Although attendance on the fair’s first day was disappointing, by Friday, Oct. 5, word of mouth had spread and the trickle of visitors began to expand. Local residents attended almost without exception, and, true to Chamberlain’s prediction, Tacoma residents began to arrive by train.

Friday’s fair visitors watched as infant Walter Durgan of Sumner was awarded the prize for Prettiest Baby. A public wedding planned for early afternoon had to be canceled when the engaged couple who were to have been married and collect an oak rocking chair and $10 worth of groceries as wedding presents developed cold feet. A cattle parade around the fairgrounds led by Oscar Showers of Enumclaw and a brief horse race helped disappointed fairgoers regain their good humor.

The first Valley Fair netted a profit of $583 and drew some 3,000 visitors. Except during World War II, the event was held annually thereafter. By the end of the 20th century, more than 1 million people attended the Puyallup Fair (as it was titled then) each year.

Source: Historylink.org, a non-profit organization, and Washington Department of Archeology and Historic Preservation.

FAIR, FOOD, FESTIVITIES: IT’S THE FAIR

This year’s Washington State Fair, in keeping with one of its annual traditions, will open in Puyallup on the Friday of Labor Day weekend. The 20-day run Sept. 1-24 (it will be closed on all three Tuesdays) will feature the usual attractions, including animals (farm and domestic), agriculture displays, commercial vendor and product exhibits, carnival rides and game booths, arts, and food (such as the fair burgers the two past fairgoers have their hands on in this photo). Big-name musical performers will star in the concert series at the grandstand, where a rodeo is also billed.
The fair is the largest one in Washington and one of the biggest in the world. Some things to know if you’re planning to attend:

  • Wear comfortable shoes and expect crowds. The fairgrounds cover 165 acres, and attendance averages 1 million people a year.
  • Admission costs $14 for adults, $12 for children 6 to 18 years old, and $12 for seniors. Kids 5 and under get in free. Everyone can enter free on opening day between 10:30 a.m. and 12:30 p.m. by donating a non-perishable food item for the Puyallup Food Bank.
  • Parking in official fair lots costs $15 on weekdays and $20 on weekends. “Premium” parking (purchased on-site) is $35, and VIP parking (purchased online) is $50. Private owners and fund-raising groups typically offer pay-to-park options. And there is some on-street parking.
  • Need other information? Call 253-841–5045 or go online at thefair.com.
The hickory crowd

Say hello (and maybe fore!) to some folks who not only talk about the old days but also keep them going.

They’re the 200 or so members of Northwest Hickory Players, an association of golfers that formed in 2014 to enjoy and promote playing golf the old-fashioned way with some of the original equipment–hickory era, pre-1935 clubs. 

The wood-shafted clubs, some more than 100 years old, are the favorite way to play for linksters such as John Quickstad of Sammamish. His clubs from 1895 because are “beautiful” and take him back to some of the ancient origins of the game in Scotland in 1851.

“I describe it as getting to play with my antiques,” he said.

The men and women in the hickory crowd play socially and competitively. They have outings to golf courses throughout the Pacific Northwest (Washington, Oregon, and British Columbia is their main focus), organize club swaps and sales, and welcome newcomers to the wood-shaft world. There are no membership costs or other obligations. On the competition side, Northwest Hickory Players has an annual state tournament (the 2023 event was staged May 21-22 in Walla Walla at Veterans Memorial Golf Course and Wine Valley Golf Course) and helped host the first two U.S. Hickory Opens on the West Coast–at Pebble Beach Resorts (Del Monte Golf Course) in California in 2017 and at Gearhart Golf Links near Seaside, Ore. in 2021. Andrew Von Lossow, a Northwest Hickory member, won at Gearhart, which itself is a blast from golf’s past. The links-style course opened in 1892 and was designed by Robert Livingston, a native of Scotland.

Northwest Hickory Players is affiliated with the international Society of Hickory Golfers (SoHG), which has about 3,000 members worldwide. One of them, an honorary lifetime member, is a Washingtonian–Jeffery Olsen of Shoreline.

Along with the U.S., countries with their own national associations include Canada, Australia, New Zealand, Japan, South Africa, and numerous European nations such as Scotland and Ireland

Credit for the organized modern pursuits of hickory-style golf in the United States generally is given to so-called “hickory hacker” events that were part of annual meetings of the Golf Collectors Society. GCS was founded in 1970 by Joe Murdoch and Bob Kuntz to share their passion for golf history and the game’s collectibles and memorabilia. Only a few dozen people were involved at first, but as the idea caught on, GCS held more meetings, some collectors and traders of wood-shafted clubs wanted to try playing with them. The rest is history.

Among the Northwest Hickory contingent, “there are a few of us that also work on the clubs–resetting heads, replacing or repairing shafts, installing grips,” Quickstad said.  “Those skills are also part of the hickory golf experience that our group and the Society of Hickory Golfers are keeping alive and hopefully passing on to others. Just in case you were wondering how we keep clubs that are 90 to 140 years old in playing condition.”

Clubs aren’t all that make hickory golfers easy to spot on a course. They also use old-style balls and wear knickers and other period clothing fancied by golfers of yore. It is, they’ll tell you, more fun than a barrel of birdies.

Here’s how Quickstad and another Northwest Hickory enthusiast Martin Pool, of Kenmore, described it in a Q-and-A with Senior Scene:

SS: How did you get involved in hickory golf? Are you a student of golf, and/or a longtime player?

Quickstad: “I’m a long time player.  I remember my maternal grandfather helping me with my game in junior high school. I then played on my high school golf team. I was intrigued by hickory golf clubs and had one from my paternal grandfather that I had tried playing with, but it had a cracked shaft and I didn’t know how to fix it at the time, so the club sat in a corner for many years. Then about 2011 I inherited my maternal grandfather’s hickory clubs. In 2012 I started looking around for hickory clubs like my grandfather’s set on the Internet and found the Society of Hickory Golfers (SOHG) website. I sent an e-mail to the SOHG contact asking about a contact in the Seattle area. I received back Rob Ahlschwede’s e-mail address and then started exchanging e-mails with him for help with building a play set. The following year, Rob let me know that a group of local hickory players were going to play at West Seattle Golf Course. By that time I’d assembled my play set, so I went to the event, played, and was hooked.”

Pool: “I’ve been playing golf for about 50 years.  When I was in college, I worked in archives and became interested in history. History and golf naturally evolved into playing with hickory clubs, which I’ve been doing for the past 25 years. I also enjoy researching and writing golf history.”

SS: Do you prefer playing with wood-shafted clubs? How would you describe the difference between them and modern equipment, both in performance and just pure fun?

Quickstad: “I do prefer playing with hickory clubs, mostly because they’re beautiful to look at and I’m playing them for the unique experience they provide. I really like playing with my clubs from 1895 with gutta percha golf balls. The clubs are all handmade and really a form of Scottish folk art. I describe it as getting to play with my antiques. That’s only in hickory golf events or when a group of us go out to play a fun round. I play modern clubs in non-hickory events or with family or friends. In my experience, I find there isn’t much difference between hickory clubs and modern clubs, other than I can hit the fall farther with modern clubs. Putting and chipping are exactly the same.”

Pool: “I play both hickories and moderns — about 50-50.  Many of our players play hickories exclusively. I marvel at how hickory clubs have withstood the test of time and that we can still play with them a hundred years later. The ball doesn’t go as far, about 90 percent of the distance with modern clubs, but that’s still remarkable for 100-year-old clubs. It’s true that hickory clubs are, as they say, “less forgiving” than modern clubs, but we joke that if you’re looking for forgiveness, then you should go to church. There is no greater fun in golf than hitting a pure shot with hickories and making birdies.” 

SS: Does it feel like stepping back in time when you’re playing with others who are all dressed and equipped the way the game was played in the hickory era, especially in tournaments? 

Quickstad: “I thought that might be the case when I first started. But the more I played, the more I realized what Rob Ahlschwede says is really true: It’s just golf.  What that means is that the golf experience transcends time. So I don’t feel like I went back in time, I feel I’m just part of a shared experience that has lasted for hundreds of years. In the case of my clubs from the 1890s, I’m playing with the same clubs that someone enjoyed almost 130 years ago. It’s the clubs and courses that really link us to that shared experience”

Pool: “Absolutely, I feel like a time traveler when I’m dressed in period clothes and playing with original clubs. If you’re a student of history, the best way to learn it is by actually experiencing it.  With golf, we’re fortunate that we can do that using authentic equipment. This is especially true when we play hickory-era courses such as Tacoma Country Club and Meadow Park (in Tacoma), which were built when hickory clubs were used.”