One main concern for today’s medical care is ensuring that we prevent illness, or detect illness early so that it can be treated quickly. That’s why annual wellness visits are an important part of your Medicare coverage.
This guide will help you understand your annual wellness visit, including who’s eligible for it, and how to schedule and take advantage of this coverage.
Let’s get started.
There are two times you are eligible for a Medicare wellness exam.
The first time is when you first enroll in Medicare. You are entitled to a “Welcome to Medicare” preventive visit within the first 12 months after you enroll in Medicare Part B. You will need to choose a medical provider that is enrolled in Medicare and accepts assignments. For your first preventive visit, your Medicare Part B costs do not apply unless the doctor performs tests or services that aren’t covered under preventive benefits.
After your Welcome to Medicare visit, you are eligible for a Medicare wellness exam once every 12 months. This is a visit that allows you to create or update your personal plan to prevent disease and disability. This wellness exam does not cost you anything unless the doctor performs tests or services that aren’t covered under preventive benefits.
What is a Medicare wellness visit? What can you expect at your annual visit?
You’ll start by filling out a questionnaire known as a “Health Risk Assessment.” This will help you and your doctor work together to create a personalized prevention plan. The goal is to help you stay healthy, understand your risk factors, and help detect any problems early.
After you’ve done the questionnaire, it’s time to review the results.
Some of the things you might discuss include:
You’ll leave the annual wellness visit aware of your current health and the steps you can take to improve or maintain your good health.
Medicare Wellness Exam Costs
How much does it cost to have a wellness visit? Most of us don’t have a lot of extra money, so it’s important to understand the costs of these visits.
In most cases, it doesn’t cost anything. Your Part B deductible and coinsurance do not apply for normal preventive benefits and your personalized prevention plan.
However, if your doctor provides additional tests and services during the visit that are not part of the preventive benefits, you may have your normal Part B deductible and coinsurance. Those services turn the visit into a normal doctor’s appointment, instead of a wellness visit.
There are a lot of common questions that Medicare beneficiaries have about wellness visits. Here are several that might help you better understand this important benefit.
Do you absolutely have to go to an annual wellness visit? The good news is that it is optional. However, it’s very helpful and can put you on a path to better health and give you a better understanding of your risk factors.
Because your Medicare Wellness Visits are not mandatory, you can definitely refuse them. However, you’ll miss out on creating a personal prevention plan that takes into account your current health and risk factors. That might mean that you don’t avert health problems that are preventable.
Medicare Advantage plans, which are full replacements for Original Medicare, are required to offer at least as much coverage as Original Medicare. That means you can expect a Medicare Advantage annual wellness visit.
Generally, you’ll find an annual preventive appointment to be cost-free, but you’ll need to look at the specifics of your plan. Wellness in Medicare Advantage might provide more preventive care in your annual appointment than Original Medicare offers as well. You’ll need to check with your provider for details.
Keep in mind as you schedule your annual wellness visit with Medicare Advantage, you will need to see a provider within the plan’s provider network to get cost-free care.
Preventing illness and addressing risk factors as early as possible is an important part of living a happy and healthy life. If you have additional questions about your Medicare coverage or need help comparing plans, contact us today!