Medicare Provides Annual Doctor Visits, but Not Regular Physicals
By the GWAAR Legal Services Team
Did you know that Medicare pays for a “Welcome to Medicare Visit” and an “Annual Wellness Visit?” It is important to recognize that neither of these visits are physical exams.
The Welcome to Medicare Visit is a one-time preventative visit. The visit must happen within one year of Medicare Part B enrollment. The goals of the visit are health promotion, disease prevention, and detection. This Welcome to Medicare Visit includes a review of your medical and social history related to your health, as well as education and counseling about preventive services. Your doctor will obtain your height, weight, body mass index, blood pressure, and conduct a vision test. The Welcome to Medicare Visit allows you to talk to your doctor about important screenings and vaccines you may need.
In addition to the Welcome to Medicare Visit, Medicare covers an Annual Wellness Visit. The Annual Wellness Visit is similar to the one-time Welcome to Medicare Visit. The Annual Wellness Visit focuses on your plan for preventive care in the upcoming year. The first Annual Wellness Visit provides a Health Risk Assessment, which will be updated in future years. If you didn’t receive a Welcome to Medicare Visit, you can still have an Annual Wellness Visit.
Medicare will only cover the Annual Wellness visit once every 12 months. Your Annual Wellness Visit should also not be scheduled within 12 months of your Welcome to Medicare visit.
When you schedule these appointments, you must state that you are scheduling the Welcome to Medicare Visit or Annual Wellness Visit. If you do not specify this, you likely will receive a regular physical exam. Medicare will never cover a routine physical exam.
What do these services cost?
You do not pay anything for the Welcome to Medicare Visit or the Annual Wellness Visit, if your doctor accepts Medicare assignment.
If your doctor performs additional tests or services during either visit, for example blood tests or lab work, the standard the Medicare Part B coinsurance (80/20%) and deductible will apply.
Note: People who are enrolled in Medicare Savings Account (MSA) plans pay 100% of the Medicare re-approved amount for their health costs (including preventive services) until their deductible is met.
Copyright GWAAR, 2018