After you join Medicare Part B, you might think you’re good to go, right? Not exactly. Getting your first “Welcome to Medicare” preventive visit within the first 12 months of Part B enrollment is an important step in ensuring that you receive preventative care services, including vaccinations, risk assessments and screenings.
When scheduling this visit, your primary care provider must accept the visit as an Initial Preventive Physical Exam to be covered by Medicare and not count toward your annual Part B deductible. At this visit, the doctor will review your medical and social history, as well as education and advice on preventative services, including:
- Measurement of height, weight, and blood pressure;
- Body mass index calculation;
- Vision test;
- Limited screenings (it is important to review this list, as additional screenings may incur coinsurance and count toward your deductible);
- Flu and pneumococcal shots;
- Review of risk for depression and other safety measures;
- Discussion of advance directive;
- Additional referrals (if needed) and a written plan for future care.
Following your Initial Preventive Physical Exam within the first 12 months of your Part B enrollment, you are eligible for an Annual Wellness Visit every 12 months to review and update your care plan for the coming year. At this visit, you and your clinician will:
- Develop or review your Personalized Prevention Plan
- Perform a Health Risk Assessment. In the initial assessment, your doctor will ask you questions about your general health, nutrition, tobacco and alcohol use, physical activity, sleep, functional status, pain, your home and safety, depression, social and emotional support, advance directives, medications, a self history and family history, allergies, and what other medical providers you are seeing.
- Additionally, your doctor will take measurements, and review prescriptions and medications for potential interactions.
Both the Initial Preventive Physical Exam and Annual Wellness Visit differ from a routine physical exam, which is not covered by Medicare and will require 100% out-of-pocket payment. If your time with your doctor involves a discussion of an illness or symptoms and your doctor recommends care or a treatment plan, you will be charged a copay and/or a deductible. Your insurance for your annual wellness visit does not cover any discussion, treatment or prescription of medications for chronic illnesses or conditions, such as high blood pressure, high cholesterol or diabetes. In this instance as well, you will be charged a copay and/or a deductible.