A Healthier Tomorrow

Imagine a Healthier Tomorrow – Make the most of your Medicare benefits

By Alison H. Page

Are you currently covered by Medicare parts A and B?  Or, will you turn 65 this year and be eligible for Medicare?  If so, there are a few things you should know.  Once you have navigated the process of enrolling in the program, the next step is to make the best use of your benefits.  

Prevention and early detection of health issues plays a big role in reducing the overall total cost of health care. The folks at the Centers for Medicare and Medicaid Services (CMS) know this and it is why Medicare offers several preventive services for little or no cost to its beneficiaries.

One such service is the Annual Wellness Visit or AWV. These Annual Wellness Visits are of three types: Welcome to Medicare, First Annual Wellness Visit, and Subsequent Wellness Visits. Don’t be too concerned about which one is right for you.  When you call your doctor’s office just ask to schedule a Medicare Annual Wellness Visit and the registration staff should be able get you scheduled with the appropriate appointment type.

Here are the basics of what these visits cover under Medicare Part B:

A “Welcome to Medicare” preventive visit: You can get this visit only within the first 12 months you have Part B. This visit includes a review of your medical and social history related to your health, and education and counseling about preventive services, including these:

• 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 visit is covered one time. You don’t need to have this visit to be covered for yearly “Wellness” visits.

Yearly “Wellness” visits: If you’ve had Part B for longer than 12 months, you can get this visit to develop or update a personalized prevention help plan. This plan is designed to help prevent disease and disability based on your current health and risk factors. Your provider will ask you to fill out a questionnaire, called a “Health Risk Assessment,” as part of this visit. Answering these questions can help you and your provider develop a personalized prevention plan to help you stay healthy and get the most out of your visit. It 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. Get details about coverage for screenings, shots, and other preventive services
• Advance care planning

This visit is covered once every 12 months (11 full months must have passed since the last visit).

You pay nothing for the “Welcome to Medicare” preventive visit or the yearly “Wellness” visit if your doctor or other qualified health care provider accepts assignment of payment from Medicare. The Part B deductible doesn’t apply.  However, you may have to pay coinsurance, and the Part B deductible may apply if:

• Your doctor or other health care provider performs additional tests or services during the same visit.
• These additional tests or services aren’t covered under the preventive benefits.

What to expect during your “Welcome to Medicare” preventive visit:

During the visit you can expect to spend the first half with a Registered Nurse, who will thoroughly review your record, collect history and screening information, and pend any tests you are due to have completed. The second part of the visit will typically be with your Primary Care Provider, who will review information collected, place any additional orders needed, and answer any health-related questions you might have.

What to bring to your “Welcome to Medicare” preventive visit:

• Medical records, including immunization records.
• Family health history. Try to learn as much as you can about your family’s health history before your appointment. The information will help you and your doctor better understand what screenings you need to get and what to watch for in the future.
• Prescription drugs. Bring a list of any prescription drugs, over-the-counter drugs, vitamins, and supplements that you currently take, how often you take them, and why.

If you are new to Medicare, will be enrolling soon, or simply want more information on available services, I encourage you to visit www.medicare.gov  to learn more about Medicare Covered Services and Annual Wellness Visits.

Remember, the prevention and early detection of health issues goes a long way in reducing the overall total cost of care for everyone. Do your part by getting your Annual Wellness Visit completed every year.