As women age, their risk of developing certain chronic diseases increases. We have the aging process itself to thank, and the loss of estrogen’s protective effects after menopause. Older women are more susceptible to conditions such as osteoporosis, which can lead to brittle bones. The chance of heart disease increases, as does the chance of developing dementia, in part because women tend to live longer than men and the risk increases with age.
Diagnosing certain conditions is more challenging because the frequency, presentation, and long-term effects of many conditions often differ in women than in men. This is a key reason not to neglect regular health checkups and wellness visits, as staying healthy through preventive care and checkups can make the health challenges of aging easier.
Health check-ups are crucial for older women
Medicare pays for annual preventive care with no out-of-pocket costs. This is especially important for women, who made up more than half (55%) of all Medicare beneficiaries in 2021. KFF’s analysis found that many people have functional impairments. These include difficulty walking, difficulty bathing, loss of vision, or other problems that significantly impact their quality of life. People 85 and older tend to have five or more chronic conditions, the treatment of which becomes more complex as they age.
Alina Salganicoff, director of women’s health policy at KFF, said women know they should take care of their health. But, “sometimes, the system is not set up for women to take care of themselves because they have competing demands, such as work or family care responsibilities.” This often results in women prioritizing limited time for themselves.
If women don’t have access to primary care providers or don’t have regular care, she said, they may skip important preventive measures like mammograms.
“Getting insurance is the first step, but many other factors affect whether women get the services they need,” Salganikov said. This includes their relationships with clinicians, their own previous experiences, access to care, fears of illness such as dementia or cancer, or social support such as transport, mobility or cognitive problems, or having someone to accompany them.
Segen Chase, an internist in private practice in Manhattan, Kansas, says that first wellness visit can be the key to everything else in treating older patients. About 35 percent of her clinic’s patients are Medicare beneficiaries, many of whom live in nearby retirement communities.
“It’s very important that we make every effort to have them visit and work with the clinic’s wellness coordinator to complete all necessary assessments,” said Chase, who is involved in the WEL leadership training program for women in medicine.
Health screenings include annual tracking of numerous behavioral and physical indicators such as vision, hearing, fall risk, sexual health, nutrition, alcohol consumption and smoking, as well as psychosocial risks such as depression, stress, loneliness or social isolation, pain and fatigue. Patients also undergo cognitive screening, which can reveal subtle changes in brain health.
Chase said health screenings may also include questions about someone’s living situation, as it can help us determine if they need extra help at home. “It also gives us an opportunity to discuss advance care planning when they’re not in a crisis situation.” Medicare pays for this as part of the Part B annual wellness visit.
According to the KFF analysis, women with Medicare have higher rates of certain health problems overall than men. Urinary incontinence (37% vs. 18%), depression (31% vs. 21%), osteoporosis (29% vs. 7%), and lung disease (20% vs. 16%) were more common among women. More common in men. Women are also more likely than men to live alone. More than one-third of women with Medicare (36%) live alone, and more than half of those over the age of 85 live alone. This increases the likelihood of loneliness and social isolation, which increases the risk of depression, dementia and stroke, according to the American Medical Association.
Wellness visits can help uncover hidden problems, and doctors and patients can work together to develop a care plan to manage these and other chronic conditions, Chase said.
What preventive women’s health services does Medicare cover?
Medicare Part B covers a range of preventive services that benefit women’s health, including:
According to the Medicare Rights Center, there are no copays, deductibles or coinsurance charges for these and other covered tests, but certain other criteria may apply. If you qualify, Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) can even help pay for osteoporosis injections and home health nurse visits to inject them.
Salgarnikov said the list of some of the screening tests covered by Medicare can seem daunting, which is why it’s so important for women to talk to a clinician and discuss their health history, risk factors and priorities. “It’s a complex process that can be difficult for people to navigate,” she said.
These shouldn’t be one-time conversations, either, Chase said. As one ages, a person’s priorities and realistic goals may change. Therefore, ongoing dialogue is key to staying healthy.
We know that certain conditions manifest differently in women, so “a lot of medicine comes back to communication, keeping the sanctity of the relationship while respecting their independence and figuring out what’s most important to that person,” she says. Chase has found that these discussions can help women learn more about their physical and emotional challenges, especially those who are caregivers. “They’re often tired but don’t want to admit it.”
Providing women with clear, simple information so they understand all Medicare benefits and get the support they need to get preventive care and other needed services can go a long way toward keeping women healthy as they age.
