Important details you need to know.
We want you to get the most from your visit. And that, in turn, will help you stay healthy and well. Because Medicare has very specific requirements for this visit, there are a few differences from the physical exam you’re familiar with, and we recommend a careful reading of these details. Let our staff know if you have any questions, or call us at 608-348-4330.
What is a Medicare Wellness Visit?
The term “physical” is often used to describe wellness care. But Medicare does not pay for a traditional head-to-toe physical. Medicare does pay for a wellness visit once every 12 months to identify health risks and help you to reduce them. At your wellness visit, our health care team will take a complete health history and provide several other services:
- A review of your medical and family history
- Screenings to detect depression, risk for falling, and other problems
- A limited exam to check your blood pressure, weight, and vision
- Detection of any cognitive impairment
- Recommendations for other wellness services and healthy lifestyle changes
Your visit will also provide a chance for you and your doctor to develop a personalized wellness plan. Based on your current health and risk factors, this will help you manage your health and prevent disease.
Medicare offers details about the Wellness Visit at the links at the bottom of this page.
What will this visit cost?
Medicare pays for some of the wellness care, but it does not pay for all the wellness care you might need. The specific items included in an Annual Medicare Wellness Visit are preventive care benefits covered by Medicare at no expense to you, and this visit is not subject to deductibles, co-insurance or co-payments. See the list under “What happens during my visit?” for the basics on what is covered.
Note that a wellness visit does not deal with new or existing health problems. By Medicare rules, that is a separate service and requires a longer appointment. Please let our scheduling staff know if you wish to discuss a new or chronic health problem, as we may need to schedule a separate appointment. A separate charge applies to these services, whether provided on the same date or a different date than the wellness visit.
If you wish to have a complete physical exam and or discuss chronic conditions, you will need to make a separate appointment. A complete physical exam may be covered by your supplemental policy, however it is your responsibility to call and check. If you make an appointment for a full physical exam in addition to your Annual Wellness Visit, you may be billed for the additional services if not covered by your supplemental plan.
If you have questions on what Medicare covers and does not cover you can call 1-800-MEDICARE (800-633-4227) or see your “Medicare and You” booklet that is published every year by Medicare and mailed to you. You can find that booklet online at http://www.medicare.gov/Pubs/pdf/10050.pdf.
What happens during my visit?
Unlike a comprehensive physical exam, your Annual Wellness Visit includes certain screening questions, vaccines, and possible referrals for additional tests or services, if needed.
During your visit, you can expect your practitioner will take each of these steps*:
- Measure your height, weight, blood pressure, and body mass index (BMI).
- Review your medical, surgical, social history (such as alcohol, tobacco, and drug use), and family history.
- Review your current prescribed and over-the-counter medications.
- Perform a basic vision and hearing test.
- Perform a basic depression and cognitive screening (e.g. memory) test.
- Complete a health risk and safety assessment.
- Discuss end-of-life planning.
- Discuss recommended preventive screenings and services you may need in the coming years.
- Discuss referrals for appropriate services or programs to help minimize or treat potential health risks.
Keep in mind that some of these items will be performed by a nurse or medical assistant.
*You and your practitioner may discuss other tests or services, too, but keep in mind the Medicare visit requirements are specific. Any other services may result in additional charges.
When am I eligible for your initial visit?
Within your first year of enrollment in Medicare, a Welcome to Medicare Exam is available to you. Also, you’re eligible for subsequent Annual Wellness Visits every 12 months.
What should I bring to my Medicare Wellness visit?
- Please come prepared to your Annual Wellness Visit with the following information:
- Updates on any medical issues from the past year.
- Your family history. Try to learn as much as you can about your family’s health history before your appointment. Any information you give your doctor can help determine if you’re at risk for certain diseases.
- A list of prescription and over-the-counter drugs that you currently take, including how often you take them and why you take them.
- A list of any other healthcare professionals that are currently involved in your care.
- Any copies of advanced directives (such as power of attorney or a living will) if not currently on file.
What are steps I can take between visits?
Keep a Healthy Weight: watch your portions, and bring to a balance the calories you eat with those you burn through activity.
Get and Stay Active: Do any physical activity you like for 20 to 30 minutes, five or six days per week. Talk to your doctor about the fight activity or exercise program for you.
Eat Real Food: American diets are often loaded with additives, especially sugar. A healthy diet is rich in different foods (real foods, not processed versions in packages). Fruits, vegetables, proteins (meat, fish, or beans), whole grains (from minimally processed rice, pasta, and cereals), and dairy products. Another helpful step is getting accustomed to reading food labels to find the added sugar and to limit saturated fats.
Think Prevention: To delay or lessen effects of diseases, get regular preventive services, such as screening tests and vaccines, such as a yearly flu shot.
Don’t Smoke: And if you do, talk to your doctor about getting help to quit.
Join our My Healthy Life Classes: Every third Tuesday, we feature a new topic in an all new seminar brought to you by experts. It’s all free and everyone is welcome. Classes begin at 6;30 pm and are held in the comfortable Conference Room in our EMS Station at 1350 Eastside Road in Platteville. Click here for event info, My Healthy Life blogs and other information.
Attend Young at Heart Super Socials: Young at Heart is a free club that connects people 50+ with healthy ideas and with their community. Because being social is also proven to benefit one’s health, we offer monthly Super Socials. These events are free, open to everyone, and include informative presentations and snacks and beverages. Young at Heart is sponsored by Southwest Health. Super socials are every second Thursday from 4:30 to 6:00 pm and are held at Park Place senior living at 1015 North Elm Street in Platteville. Click here for more information about Young at Heart.
More information on the Medicare Annual Wellness Visit
We think the details above cover the basics. But, if you’d like more information, Medicare offers details about the Wellness Visit at the links at these locations online:
https://www.medicare.gov/coverage/preventive-visit-and-yearly-wellness-exams.html.