Don't you think Medicare's focus on treatment rather than prevention is backwards?

Question

Steven Bleicher · Accepted Answer

I do agree. The dilemma here is that due to the scarcity of Primary doctors in the US, focusing on prevention rather than treatment (in the long run) will be less expensive to Medicare. In our global economy, this is "the formula" that healthcare has adopted. Moreover, there are two specific kinds of "codes" that are placed in your record after a visit: A) "Preventive", and, B) "Diagnostic", the latter of which will come out of either Part A (in-patient) and Part B (out-patient) Medicare, therein costing the Feds the extra money. However, when a person sees her/his doctor without complaining of any type of pain, that visit is automatically coded as Preventive, thus costing the patient more $$ rather than the Federal government. The exception to that is, for example, if you're having a colonoscopy and the surgeon removes some polyps which have to be analyzed, if it has been found to be cancerous, it will change codes from a preventive visit to one that needs further discussion and thus is now diagnostic.

Answered by Steven Bleicher on April 17, 2025

Broker Licensed in AZ

Answered by Steven Bleicher Medicare Insurance Agent

Steve and Sue Brauer · Answer

Yes... but that is the cornerstone of the Medicare Advantage programs. They take a proactive approach to healthcare and are incentivized by the Federal Government to do so.

Kerwyn Jones · Answer

That's a subjective question and my opinion may not be accurate. Medicare has its purpose and many Americans depend on it for care.

James Carlson · Answer

Medicare is a plan that provides seniors after 65 with medical options to both treat ailments and to provide relief of issues caused by years of prevention. Aging is the issue. It is more likely that seniors will have medical treatment due to disease and lack of preventive treatment earlier in life. Medicare assures that treatment can lead to prevention by allowing beneficiaries to reach out to clinics to receive treatment and help provide a better, healthier life style.

Answered by James Carlson on September 4, 2025

Broker Licensed in MN

Answered by James Carlson Medicare Insurance Agent

Jennifer Whitworth · Answer

An interesting debate for sure. Medicare's emphasis on treatment rather than prevention raises important questions about the long-term effectiveness of the healthcare system. Prevention rather than treatment after the fact could be a more sustainable and effective approach to better health out comes. It is important to prioritize intervention before real health issues arise, so as to avoid the increasing cost of care in treating real issues when they are identified. So since it is not just Medicare I think our entire health care system should make a shift towards preventive care that could not only improve the overall health of populations but also reduce the financial burden on Medicare by decreasing the incidences of chronic diseases.

Answered by Jennifer Whitworth on October 7, 2025

Broker Licensed in MA, CT, FL & 5 other states

Answered by Jennifer Whitworth Medicare Insurance Agent

James Romeo · Answer

This is a complicated answer, how I look at it is Medicare is Based on Western Medicine that that focuses on treatment of conditions, so Medicare follow that process. However in my many years of doing this I have seen a lot of folks find out they have major health conditions because of the regular screenings that are at no cost to you on your policies. The plans do encourage you to use them and take advantage of no cost screenings and some doctor visits. So know that you are well covered. Now some plans do include no cost to you benefits, like gym memberships, access to over-the-counter products like vitamins and supplements, and other benefits that take aim at getting you and keeping you healthy! Make sure you choose a plan that fits your needs and lifestyle.

Answered by James Romeo on April 9, 2025

Broker Licensed in MN

Answered by James Romeo Medicare Insurance Agent

Kelly Linster · Answer

Yes I feel treatment first vs. prevention is a little backwards in my honest opinion. But as an advisory, I advise and customer chooses which route to go.

Erlynne (Elle) Massie · Answer

In my opinion, I believe Medicare does focus on prevention, and my reasons are these:

1. Medicare's preventative annual physicals are extremely comprehensive, and are covered at $0 copay to the beneficiary. They cover over 35 health screenings for every part of the body, cancer screenings, mental health screenings, tobacco cessation, and many more.

2. Routine colonoscopies, mammograms & PSA screenings are also covered at $0 copay.

3. Vaccinations as recommended by the Advisory Committee on Immunization Practices (ACIP) are covered by Part D at $0 copay. These include the flu shot, pneumonia, COVID, tetanus and other routine immunizations. About 3 years ago, the instructions even encompassed the shingles vaccine at $0, which I believe to be extremely proactive in preventative health measures.

4. Primary Care Physicians and practices are subject to rigorous CMS standards that require alignment with strict protocols in preventative health.

David Ryerson · Answer

Great question, and it addresses an issue in healthcare; preventing a disease, and/or catching it in early stages is FAR better than waiting till it is advanced to begin treatment. To help with this, some insurance companies offer incentives to their members to participate in activities that will help them become and stay healthy. Some health plans offer gym membership, in-home nurse visits to do a basic exam, and other perks. Medicare also has a long list of preventative exams and screenings that are covered 100%. Really good question!

Answered by David Ryerson on October 27, 2025

Agent Licensed in AR, KS, MO & OK

Answered by David Ryerson Medicare Insurance Agent

Steve Schnell · Answer

All healthcare plans only cover SOME preventative procedures, and each plan/company decides which ones they cover.
However, there are companies in some states who offer plans that cover ALL Preventative. Hopefully you can find an agent who contracts with one of them.

Fred Manas · Answer

While Medicare has historically emphasized treatment, it also increasingly acknowledges the importance of prevention. Medicare does cover a wide range of preventive services, and it also includes the Annual Wellness Visit, a key element of preventative care. This focus on prevention is crucial for improving health outcomes and potentially reducing long-term healthcare costs. 
Here's a more detailed look:
Medicare's Coverage of Preventive Services:
Medicare covers a variety of preventive services, including screenings for conditions like heart disease, diabetes, and cancer, as well as counseling for smoking cessation and healthy eating habits. 
Annual Wellness Visit:
This visit, which is a key component of Medicare Part B, focuses on creating personalized plans that emphasize early intervention and proactive health management. 
Benefits of Prevention:
Preventive care can help individuals stay healthy, reduce the risk of developing chronic diseases and disabilities, and potentially increase longevity, says the National Council on Aging (NCOA). 
Cost Savings:
By detecting health problems early, preventive care can lead to more effective treatment and potentially lower long-term healthcare costs, notes ChartSpan. 
Focus Shift:
While Medicare has traditionally been focused on treatment, there's a growing understanding that proactive preventive care is vital for overall health and well-being. 
Medicare Advantage:
Some Medicare Advantage plans are demonstrating strong performance in preventive care, reports AHIP. 
Importance of Early Intervention:
Detecting health problems early allows for more effective treatment and can sometimes prevent the development of serious conditions.

Vachik Chakhbazian · Answer

Medicare now offers a range of preventive services, and the shift towards Medicare Advantage plans and value-based care emphasizes a more proactive approach.

Andrew Kramer · Answer

Why do you think Medicare focuses only on treatment? Isn't the purpose of your annual physical a focus on prevention, to catch issues before they become serious? It turns out that 65% of Medicare recipients who are either on original Medicare, or a PPO Advantage plan, do NOT get their annual physical, rather they jump to specialists, thinking they get better care from a specialist rather than their PCP! And their health is worse than those on HMO Advantage plans whose PCP requires them to get their annual physical. So whose fault is it that many Medicare recipients are getting treatment rather than prevention?

Answered by Andrew Kramer on December 3, 2025

Agent Licensed in FL

Answered by Andrew Kramer Medicare Insurance Agent

Carol Thompson · Answer

If preventative tests are available and you take advantage of those then there will be less treatments or ailments can be diagnosed early on.

Suzanne Lamperti · Answer

O agree with you on that. Medical professionals are taught to focus on treatments instead of finding out the cause .the more they keep prescribing treatments, the more money they make.

Michael Kim · Answer

That's why getting a Medicare Advantage Plan is more focused on prevention. On the Medicare Advantage Plan you can get a gym membership without any monthly premiums as long as the gym is in the network.

Answered by Michael Kim on May 4, 2026

Agent Licensed in NV, AR, AZ & 18 other states

Answered by Michael Kim Medicare Insurance Agent

Mel Stevens · Answer

I don't think Medicare is based on treatment versus prevention.   In fact, I believe the opposite is true as Medicare plans will provide incentives for items like completing an annual exam, lab work, cancer screenings etc. I believe docs are on the same page as they want healthy patients also.  If you want to keep up on health maintenance and get incentivized for doing so, then make sure you are aware of benefits your plan offers.  

When it comes to treatments, that depends on the philosophy of the doctor and the facilities which you visit.  Some docs will recommend a treatment or for example a surgery that sometimes may not be medically necessary.  If a particular treatment or especially an evasive procedure is recommended by a doc, it's always a good idea to get a second opinion.   Especially if you are second guessing in your head whether or not it's necessary or perhaps there may be a better solution.  A few years back, a doc recommended a leg amputation up to his knee for one of my clients.  He decided to get a second opinion and guess what, today he's walking around with both feet.

Linda Davies · Answer

Medicare Part B (Medical  Insurance) covers preventative and screening services at no cost to the consumer if you get the services from a health care provider who accepts assignment.

Here is a list of those services found on Medicare.gov.:

Description
Preventive services help you stay healthy, detect health problems early, determine the most effective treatments, and prevent certain diseases. Preventive services include exams, shots, lab tests, and screenings. They also include programs for health monitoring, and counseling and education to help you take care of your own health. You can log in to your secure Medicare account to check your preventive services.

Coverage details
Abdominal aortic aneurysm screenings
Alcohol misuse screenings & counseling
Bone mass measurements
Cardiovascular disease screenings
Cardiovascular disease (behavioral therapy)
Cervical & vaginal cancer screenings
Colorectal cancer screenings
Blood-based biomarker tests
Colonoscopies
Computed tomography (CT) colonography
Fecal occult blood tests
Flexible sigmoidoscopies
Multi-target stool DNA tests
Counseling to prevent tobacco use & tobacco-caused disease
Depression screenings
Diabetes screenings
Diabetes self-management training
Glaucoma screenings
Hepatitis B shots
Hepatitis B virus (HBV) infection screenings
Hepatitis C virus screenings
HIV screenings
Lung cancer screenings
Mammograms (screening)
Medical nutrition therapy services
Medicare Diabetes Prevention Program
Obesity behavioral therapy
One-time “Welcome to Medicare” preventive visit
Pre-exposure prophylaxis (PrEP) for HIV prevention
Prostate cancer screenings
Sexually transmitted infections screenings & counseling
Shots:
COVID-19 vaccines
Flu shots
Hepatitis B shots
Pneumococcal shots
Yearly "Wellness" visit

Mark Walker · Answer

No - I don’t think it is backward to focus on treatment rather than prevention since all the preventative measures don’t always work to keep people healthy. To have a focus on cures or treatment to become cured of an illness is equally or actually more important. 

Thanks

Judi Norton · Answer

Yes.  A more natural approach to health for long term is better than providing a quick fix to possibly a surface problem.

Diana Muhammad · Answer

In truth, preventing the need for treatment is a great thing, makes for a healthy society. If the food industry and environmentalists followed suit the society would probably need less treatment. It's the balance we seek

Answered by Diana Muhammad on September 23, 2025

Agent Licensed in IL, CA, FL & 8 other states

Answered by Diana Muhammad Medicare Insurance Agent

Rachael Metcalf · Answer

I do not. Medicare does not focus on treatments..... that would be your doctor. Medicare has a huge and I mean huge list of preventative tests, immunizations, shots and visits that are all covered by Medicare at no cost to the Medicare beneficiary. So, to me they focus more on keeping you healthily, so you have less treatments.

Answered by Rachael Metcalf on May 5, 2025

Agent Licensed in TN, FL, GA & 5 other states

Answered by Rachael Metcalf Medicare Insurance Agent

Elliot Andrews · Answer

This is not a problem specific to Medicare, but rather to the overall US health care system. However, there are several options available through Medicare Advantage plans that allow beneficiaries to take a much more preventative approach to their health. These plans often include incentives for healthy lifestyle activities, coverage/reimbursement for gym memberships, and benefits to cover supplements, vitamins, and healthy foods.

Answered by Elliot Andrews on December 13, 2025

Agent Licensed in IN, FL, MI & OH, SC, TX & WA

Answered by Elliot Andrews Medicare Insurance Agent

Donna Hernandez · Answer

I believe Medicare is focused on being pro active with the seniors health since they will often offer a set of benefits aimed towards preventive services

Randy Sanchez · Answer

I think both are needed. 
In todays plans, like Medicare Advantage plans, there are a number of preventative measures set up. Such as, preventative screenings like colonoscopy's, mamograms, wellness visits, cancer screenings, and more. What's great, these typically come at no cost to the Medicare beneficiary which encourages one to act on these. 
In addition, treatment is a must in order for one to get the care, comfort, and healing they need to get beyond an ailment. 
I hope this helps.

Mirian Mercado · Answer

Prevention is covered today, a wide range of preventive services such as
Annual wellness visits
Vaccines like flu, covid, pneumonia 
Cancer screening mammograms, colonoscopies, etc
Diabetes and cardiovascular screenings 
Tobacco cessation counseling

Terri Curcio · Answer

Not at all - preventive tests, procedures and exams are at no charge. I review the literature with my clients, especially all of the preventive services offered at no copay or coinsurance. And, I kindly explain don't get caught up in self diagnosing yourself with the assistance of Google... make it a habit to get your preventive care annually. Make it a habit!!

Answered by Terri Curcio on October 6, 2025

Agent Licensed in OH

Answered by Terri Curcio Medicare Insurance Agent

Daniel Young · Answer

The Focus needs to be on both.  A good PCP will teach preventative as well as treatment.    
There are more and more doctors/clinics doing both.

Lawanda Radford · Answer

You're absolutely right to raise that point—yet focusing more on prevention could help seniors stay healthier and avoid serious issues down the line. Thankfully, Medicare has been adding more preventive services in recent years, and that’s a step in the right direction.

Answered by Lawanda Radford on May 8, 2025

Agent Licensed in GA, AZ, FL & 10 other states

Answered by Lawanda Radford Medicare Insurance Agent

Kimberly Hill · Answer

I believe Medicare's focus on treatment rather than prevention is backwards. By providing options for prevention such as more frequent testing for family health issues instead of waiting for symptoms to occur could actually catch a thing earlier and prevent terrible suffering later on. Example: If colon cancer is common in a family's history, instead of testing once every 10 years, per Medicare's timeline; a person could/should be allowed testing every 2-3 years.
That would exponentially decrease their potential for developing full blown colon cancer and not knowing it until much later on when treatment may be ineffective.

Don't you think Medicare's focus on treatment rather than prevention is backwards?

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Don't you think Medicare's focus on treatment rather than prevention is backwards?

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