Greetings, Savvy Senior
Are yearly physicals covered by Medicare? Since I turned 50, I’ve had a physical every year. When I enroll in Medicare in a few months, I’d like to know what it covers.
Nearly 65
To Almost,
Medicare covers a one-time Welcome to Medicare checkup in the first year following Part B enrollment, but it does not cover yearly physicals. Following that, it includes yearly wellness appointments to monitor your health. Here are some things to be aware of.
Physical vs Wellness Exam
Even if you don’t have a specific ailment or danger, a doctor checks you, may perform bloodwork and other tests, and searches for issues during a yearly physical.
Annual wellness visits and the Welcome to Medicare checkup are not the same. Their primary focus is on preventive care.
In addition to reviewing your risk factors, your doctor will create a customized health plan for you, make sure you have received the most recent flu and cancer screenings, and maybe recommend additional tests. Below is a summary of the possible contents of these tests.
Welcome to Medicare Checkup
This is an overview of Medicare that emphasizes disease prevention, health promotion, and detection to keep you healthy. It’s a chance for your physician to evaluate your condition and develop a treatment plan. During this appointment, your physician will:
- Take your height, weight, and blood pressure measurements, and calculate your body mass index (BMI).
- Ask about your personal and family health history.
- Give you referrals for other care as needed.
- Assess your potential for depression.
- Provide a simple vision test.
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Recommend vaccines, tests, screenings and other preventive services you need to stay
healthy . - Offer to talk with you about creating advance directives.
Annual Wellness Visit
Some of the components of the Welcome to Medicare checkup are also included in this appointment. Your doctor will, for instance, go over your medical history, take your vital signs, and give you a chance to discuss advance directives. Additionally, your physician might offer the following services:
- Create a screening checklist for recommended preventive services for the upcoming year.
- Look at health risks and treatment options.
- Perform a cognitive assessment to look for signs of dementia.
- Provide personalized health advice.
- Review your current prescriptions.
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Study risk factors for opioid problems if you have a prescription for opioids, and screen for
potential substance use disorders .
Medicare Coverage
Medicare Part B covers the yearly wellness checkup and Welcome to Medicare completely, with no out-of-pocket expenses. Although the Welcome to Medicare visit is not required to be eligible for subsequent yearly wellness visits, be aware that Medicare will not cover wellness visits during the first 12 months of your Part B coverage.
The practitioner might prescribe extra tests or procedures during these visits, which could incur Medicare deductibles, copayments, or coinsurance.
To make sure Medicare covers it, make sure to specifically request the annual wellness visit or Welcome to Medicare checkup when you make your appointment. If not, you can be required to pay for the visit.
In order for the wellness visits to be covered if you are registered in Medicare Advantage, you will most likely need to use an in-network provider. In addition to the wellness visit, some Medicare Advantage plans also cover yearly physicals. For specifics, review your strategy.
Questions and comments can be sent to Savvy Senior at P.O. Box 5443, Norman, OK 73070, or to [email protected].
