Medicare wellness visits
Medicare provides coverage to eligible enrollees for three different preventive care visits and encourages individuals to seek these health services to develop a personalized care plan. These wellness visits are not the routine yearly physical checkups that we have become accustomed to, but are preventive in nature and enrollees will notice a difference in how these services are delivered. Copayment, coinsurance, and the Medicare Part B deductible are waived for these visits. Please be aware that you may be charged a co-pay or deductible for services that are provided or tests scheduled that are beyond the actual Medicare Wellness Visit.
- The welcome to Medicare visit: A one-time free and easy benefit that helps you and your doctor plan for your health.
- Initial annual wellness visit: Designed to create a personal plan to prevent disease.
- Subsequent wellness visits: Your path to staying healthy.
More details about what's covered and the wellness visit components can be found here or online at medicare.gov.
The terms "Preventive Exams" and "Yearly Physicals" are often use interchangeably, however for insurance purposes it's important to differentiate.
Preventive exams include a review and update of your medical & family history, providers & suppliers, risk factors, immunizations and screening schedule. Preventive exams, sometimes called a routine check-up or preventive visits, are different than an office visit scheduled to discuss a specific medical problem. You would see your doctor, nurse practitioner or physician's assistant for a preventive visit when you feel healthy. It may include care like an exam, checking your blood pressure, or getting recommended vaccines. Yearly physicals or office visits on the other hand, would include checking on symptoms to treat a specific medical condition or problem.
Costs: Your preventative visit will first be billed to your insurance. Based on your insurance plan, you may be responsible for deductibles, co-pays and co-insurance for fees not covered by your insurance company. If medical issues outside of those described above for preventive exams are identified and addressed at your visit, additional charges may be incurred, or your provider may request you schedule a separate visit to address them.
What to bring:
- Your insurance card.
- Any immunization records or advance directives not already in your LRH medical records.
For questions or verification of your coverage and/or benefits, please contact your insurance carrier directly at the number on the back of your insurance card.