Medicare Preventative coverage and the “Yearly Wellness Exams” are a bit more extensive and personalized than a standard physical. Just like with regular health insurance and getting your annual physical though, Medicare Part B also covers an annual standard physical from your doctor. There’s no out-of-pocket cost for this exam if you have Part B and your doctor accepts Medicare.

The only costs that you could incur would be if you had any special tests completed, or any tests or services completed that weren’t covered under the Medicare preventative benefits. A Medicare Supplement insurance plan would help pay some of these costs, if applicable. Getting these exams are important!

Medicare Preventative Exam

Within the first 12 months of having Medicare Part B, you get a “Welcome to Medicare” preventative visit- so don’t delay!

So, exactly what does this preventative exam cover during the visit? It includes a review over your medical and social history relating to that of your health, education, and counseling about preventative services. Some of these services are as follows:

• Certain screenings, shots, and referrals for other care, if needed
• Height, weight, and blood pressure measurements
• A calculation of your body mass index
• A simple vision test
• A review of your potential risk for depression and your level of safety
• An offer to talk with you about creating advance directives
• A written plan letting you know which screenings, shots, and other preventive services you need
• This is a one-time only exam, however you can still get  but you don’t need this visit in order to be covered for the yearly wellness exams

Yearly Wellness Exams

If you’ve had Medicare Part B for longer than 12 months, you can get this visit to develop or update an individualized prevention assistance plan. This is to help prevent disease and disability based on your current health and risk factors. Your provider will ask for you to fill out a questionnaire. This is known as a “Health Risk Assessment”. Answering this will help develop a prevention plan with you and your provider to help you stay healthy. This can also include:

• A review of your medical and family history
• Developing or updating a list of current providers and prescriptions
• Height, weight, blood pressure, and other routine measurements
• Detection of any cognitive impairment
• Personalized health advice
• A list of risk factors and treatment options for you
• A screening schedule (like a checklist) for appropriate preventive services
• Advance care planning

A yearly wellness visit is covered once every 12 months. However, you must wait 11 full months since the last visit… in order for it to be covered.

Important Information

If you have Medicare Part B, these visits are completely covered. So don’t worry about having to pay out-of-pocket expenses for these services! The Part B deductible does not apply with these visits as well.

Any additional services performed or services that are not covered under the Medicare preventative benefits, are subject to Medicare coinsurance or the Medicare Part B deductible.

Important: Your provider may suggest getting services more often than Medicare covers. Or they may recommend services that Medicare doesn’t cover whatsoever. If that applies, you may have to pay some or all of the costs of these services. If your provider feels it’s in your best interest regarding your health prevention plan, it may be best to have them done. You always have the right to deny these additional services if desired. Be sure and to ask your provider any questions you have so you understand as to why certain services are being suggested and whether they are covered with Medicare! A Medicare Supplement plan, also known as a “Medigap” plan, can help pay some of the costs that Medicare Part A and Part B do not pay.

Questions and Concerns

If you still are unsure about the information in this article, feel free to contact us! We’ll be more than happy to assist you in any way that you need. You can either contact me directly at 888-901-4870 or simply use this online contact form and I’ll respond as promptly as possible. Let us know what we can do for you! Ultimately, there’s no cost for our services! We’re here for you however you need. So contact us today and you’ll be in good hands!

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