Does Original Medicare Cover Annual Physicals?
Medicare offers an "Initial Preventive Physical Examination" (Also known as a "Welcome to Medicare” examination) when you are first enrolled in Medicare coverage. So if you are enrolled in Medicare Part B coverage, then you will be eligible for an "Initial Preventive Physical Examination” visit. There is no cost for this exam as long as you visit a doctor and they accept assignment (Original Medicare). This "Initial Preventive Physical Examination" is a one time visit that you can have any time during the 12 month period following your Part B insurance start date. After that, your Medicare coverage includes only "Annual Wellness Visits."
What is the “Initial Preventive Physical Examination?”
During your Initial Preventive Physical Examination visit, your health care provider will check your vital signs, including weight, height, blood pressure, and vision. They will also make sure that all your preventive screenings and services are up to date. Depending on your health or family history, your physician may order further tests. The main purpose of the “Welcome to Medicare” visit is for your health care provider to create a personalized prevention plan for your health care needs.
Annual Wellness Visit
Your Medicare Part B coverage includes preventive services, including an “Annual Wellness Visit." Once you have had your Medicare Part B for 12 months, you are eligible for this annual check up. It does not cost anything, if the health care provider doing your exam accepts Medicare assignment. Note: If you have additional tests or services that are not covered by your preventive benefits, you may be responsible for coinsurance and Part B deductible costs.
The objective of the annual wellness visit is to gather and review information to update your personalized prevention plan and keep you on track for good health.
At your Annual Wellness Visit, your physician will check your height, weight, blood pressure, any other necessary measurements, and evaluate you for cognitive impairment. Your physician will give you health advice based on your results. He/She will also let you know what your risk factors are, and offer treatment options, if you require them.
With Medicare Part B, you do not have any out-of-pocket expenses for your annual wellness visit unless you have tests or anything else done that are not covered under the annual wellness visit. It is best to ask before they do any additional tests or procedures to be sure and at least know in advance if you will be responsible for any additional charges.
For a related blog post I wrote a while back, click on the web link below:
Medicare - Physical Exam Versus Wellness Visit
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