A Medicare “Wellness” visit is not a physical.
by Susan R. Tolbert, Licensed Health Agent
The Medicare program offers Wellness visits to their beneficiaries covered at 100%. During the first 12 months that an individual has Part B, it is referred to as a “Welcome to Medicare” preventive visit. This visit with your medical provider is about reviewing your medical history, learning about preventive services, screenings and shots that your doctor may recommend for you at future dates.
After an individual has been on Part B for longer than 12 months, he or she can receive a yearly “Wellness” visit. This Wellness visit focuses on education and developing a plan with your physician to prevent disease and stay healthy. One of the tools providers will use to develop a wellness plan for Medicare beneficiaries is a Health Risk Assessment. The Health Risk Assessment is a questionnaire that patients answer about their health and lifestyle. Like the “Welcome to Medicare” visit, the yearly Wellness visit is covered at 100%. The Medicare Wellness visits have often been described as “having a conversation with your doctor” and working on a plan for future care. Additionally, the Wellness visits include memory testing also called cognitive testing.
It is very easy to associate a Medicare Wellness visit with a physical because they are both often referred to as types of preventive services. Additionally, in the under age 65 health insurance market, most members can receive an annual physical covered at 100%. In transitioning to Medicare, it is important to know that the Medicare Wellness visits will not include an actual physical, where an examination is performed and blood is taken for lab analysis. If an examination or blood work is taken on a Wellness visit, please be aware you will likely incur charges. If you have any questions or concerns, please ask your provider to clarify the type of visit and services that will be given on an appointment. While Medicare covers many preventive services, at no cost share, including colorectal cancer screenings, mammogram screenings, cervical cancer screenings, prostate cancer screenings, and cardiovascular disease screenings, annual physicals are not covered by Medicare.
Please note some Medicare Advantage Plans may cover an annual physical whereas Original Medicare does not. If you have any questions about your particular coverage and how if may affect you or your situation, please feel free to reach out to me at susan@newbrookeinsurance.com.