Dear Savvy Senior,
Can you give me the recommended health screenings for seniors and which ones Medicare (Part A or B) pays for?
Healthy at 64

Dear 64
Outside of eating a healthy diet, regular exercise and not smoking, health screenings (tests or examinations that help find health problems early on, when they’re easier to treat) are the best way to stay healthy as you age. Here are the key screenings you should be aware of and how they work with Medicare (also see www.ahrq.gov/ppip/50plus).

Health Screenings
When you sign up for Medicare (Part B), be sure to take advantage of their one-time “Welcome to Medicare” physical, where all new enrollees can get a thorough physical examination within the first six months. Other important screenings tests include:
• Blood pressure checks: More than 65 million American adults (1 in 3) have high blood pressure, a leading cause of stroke and heart attack. Get it checked once a year. More frequent if your pressure is above 130/85.
• Cholesterol checks: Too much cholesterol can clog your arteries and is a major cause of heart disease. Get checked at least every five years, more frequently if you smoke, have diabetes or a family history. (Medicare offers a cardiovascular screenings once every five years that checks cholesterol, lipid and triglyceride levels).
• Colorectal cancer tests: Colorectal cancer kills 58,000 Americans each year, half of whom could be saved with routine screenings. Begin regular screening starting at age 50. Your doctor can help you decide which test is right for you. (Medicare covers four screening tests.)
• Diabetes test: Millions of people have diabetes and don’t even know it. Every three years, have your blood glucose checked. If you’re obese, have high blood pressure, high cholesterol or have a family history of diabetes, check it yearly. (Medicare covers diabetes screening for those at risk for the disease.)
• Mammograms: The risk of getting breast cancer increases with age. After age 40, annual mammograms are recommended for all women. (Annual mammograms are covered by Medicare.)
• Pap smear and pelvic exam: Pap smears are recommended every three years to detect cervical cancer. However, women who’ve had a total hysterectomy, or who are age 65 or older and have had three negative pap smears in a row, usually don’t need to be tested. Pelvic exams are recommended annually. (Medicare covers both tests every 24 months, or once a year for high-risk women.)
• Prostate cancer screening: Tests such as a PSA (prostate-specific antigen) blood test or a digital rectal exam can help detect prostate cancer and should be part of an annual checkup starting at age 50. (Medicare covers these tests annually.)
• Osteoporosis test: All women at age 65 should get a bone density test to screen for osteoporosis. You may need screening earlier if you’re at increased risk. (Medicare covers the bone density test once every two years)
• Vaccinations: People over 65 should get a pneumococcal vaccine to protect against pneumonia. Anyone over 50 should get a yearly flu shot, and a tetanus booster is recommended every 10 years. (Medicare covers flu, pneumococcal and Hepatitis B shots.)
• Vision: Eye diseases, such as glaucoma, macular degeneration and cataracts, are common with age. Get your eyes checked every year or two after the age of 65. (Medicare pays for annual glaucoma screenings for high-risk beneficiaries. They also cover cataract surgery and one pair of eyeglasses after surgery, and some macular degeneration treatments.)
• Other screenings: It’s also important to have your hearing tested by an audiologist every two or three years; have routine dental checkups at least once a year; and have annual skin examinations done by a dermatologist to check for skin cancers. (None of these are covered by Medicare.)

Savvy Note: As always, talk to your doctor about which tests are right for you, when you should have them, and how often.

Medicare Coverage
Out-of-pocket costs for Medicare’s preventive services will vary. Some are completely free, while others will cost you 20 percent of the Medicare-approved amount. For more information visit www.medicare.gov/health/overview.asp, or call 800-633-4227 and ask for a free copy of the “Guide to Medicare’s Preventive Services” (publication 10110).

Dear Savvy Senior,
Can you give me some tips on how to make a home more energy efficient? My 74-year-old mother lives on a limited income in an old house and her utility bills are extremely high. What all can we do to cut her cost without spending a fortune?
Cost Cutting Ken

Dear Ken,
High energy prices over the past few years have caused millions of Americans to evaluate their homes energy-efficiency. But by making just a few simple changes, you can significantly reduce your mother’s energy bills. Here’s what you should know.

Energy Audit
A good first step in making an older home more energy-efficient is to do or get an energy audit – that evaluates how much energy the home uses, pinpoints problem areas where the house is losing or wasting energy and what you can do to correct it. Energy audits cost up to $400 but some energy companies provide free audits for low-income households. To locate an energy auditor, call your local utility companies or state energy department (see www.naseo.org for a list). Here are some other resources that can help.
• Residential Energy Services Network: A nonprofit organization that provides an online directory of certified home energy auditors at www.natresnet.org.
• Department of Energy: Offers great information and resources including a do-it-yourself home energy audit checklist that can help you spot problems. Visit www.eere.energy.gov/consumer.
• Home Energy Saver: A government-sponsored site (http://hes.lbl.gov) that offers a free online energy auditing tool.

Energy Saving Tips
Here are some tips that can help make your mom’s home more energy-efficient and cost-effective.
• Weatherize: Plug leaks around windows, doors, ducts, pipes and electrical outlets with caulking and weather-stripping and close fireplace damper when not in use. Insulating window films are also an inexpensive way to help seal drafty old windows.
• Insulate: Add insulation to attic, walls and basement. Also make sure air ducts are insulated and sealed. See www.simplyinsulate.com.
• Tune-up: Get a professional to service her heating and cooling systems every year and change the filters. Costs range between $50 and $100.
• Smart thermostat: Invest in a programmable thermostat ($50 to $125), which can be set to lower temperatures at night or when she’s away.
• Vent check: Be sure furniture and drapes don’t block the air flow from the floor vent.
• Water heater: Reduce the hot water heater to warm or 120 degrees Fahrenheit and make sure it has an insulating blanket.
• Light for less: Replace your light bulbs with new compact fluorescent (CFLs), which use 75 percent less energy. And don’t forget to turn off everything (lights, television, computer, etc.) not in use.
• Free heat: In the winter, keep blinds or drapes open on sun-exposed windows during the day and closed at night to conserve heat. Also, close off all unoccupied areas of the house.
• Home upgrades: If your mom’s house has leaky single pane windows, old appliances, an outdated furnace and more, consider upgrading with efficient, money saving products that have the Energy Star label – the government-backed symbol for energy efficiency. See www.energystar.gov for a comprehensive list of home improvement products and where to get them, or call 888-782-7937.
Savvy Tips: For more energy savings tips get the Department of Energy’s free booklet “Energy Savers: Tips on Saving Energy & Money at Home” by calling 877-337-3463. Also, the American Council for an Energy-Efficient Economy offers good information on energy efficiency tax incentives, rebates and more at www.aceee.org.
If your mom lives on a tight budget there are several resources that may be able to help her with her utility bills, including:
• Low Income Home Energy Assistance Program: A federally-funded program that helps eligible low income homeowners and renters meet their home heating and/or cooling needs. Visit www.acf.dhhs.gov/programs/liheap or call 866-674-6327.
• Weatherization Assistance Program: Helps lower-income people make their homes more energy-efficient. Visit www.eere.energy.gov/weatherization or call 800-363-3732.