What can seniors do to stay healthy? Medicare's Annual Wellness Visit is a great place to start.
If you’re a Medicare beneficiary or you’re caring for someone who is, you need to know about Medicare’s Annual Wellness Visit. This is the one time each year when a Medicare beneficiary works with his or her physician to develop a personalized prevention plan and access Medicare’s free preventive screening services. “These benefits are designed to keep Medicare beneficiaries healthy, rather than just paying for treatment when they are sick,” said Emily Monarch founder of Elder Law Solutions in suburban Louisville, Kentucky.
During your love one’s very first Annual Wellness Visit, his or her health care provider will create a prevention plan. To develop the plan, the health care provider will:
• Complete a health-risk assessment
• Check height, weight, blood pressure, and body mass index
• Take your loved one’s medical and family history
• List current medical providers, durable medical equipment (DME) suppliers, and medications
• List medications taken, including prescription drugs, vitamins, and supplements
• Develop a schedule for Medicare screening and preventive services that will be needed over the next five to 10 years
• Identify risk factors and current medical and mental health conditions along with related current or recommended treatments
• Screen for cognitive impairment, including diseases such as Alzheimer’s or other forms of dementia
• Review risk factors for depression
• Review your loved one’s functional ability and level of safety, including screening for hearing impairments and fall risks
• Offer health advice and referrals to health education or preventive counseling services or programs aimed at reducing identified risk factors and promoting wellness, such as weight loss, physical activity, smoking cessation, fall prevention, and nutrition.
Annual Wellness Visits after your loved one’s first visit may be slightly different. As part of subsequent wellness visits, the health care provider will typically:
• Update the health-risk assessment your loved one completed
• Update your loved one’s medical and family history
• Check weight and blood pressure
• Update the list of current medical providers and suppliers
• Screen for cognitive issues
• Update the written screening schedule from previous wellness visits
• Update the list of risk factors and conditions and the care being received or recommended
• Provide health advice and referrals, to health education or preventive counseling services or programs.
Who pays for these visits? “Original Medicare covers the Annual Wellness Visit with no coinsurance or deductible if your loved one sees health care providers who accept the Medicare-approved amount in full,” noted Monarch. “Medicare Advantage Plans cover all preventive services the same as Original Medicare. Advantage Plans are not permitted to charge coinsurances, copays or deductibles for preventive services that Original Medicare does not charge for as long as the patient sees in-network providers.”
Although Medicare’s Annual Wellness Visit is not the same as an annual physical exam, it gives your loved one the opportunity to talk with his or her primary care doctor about health concerns. After the initial Annual Wellness Visit, your loved one is eligible for a follow-up wellness visit every 12 months.
Keep in mind that if your loved one receives any additional services or screenings during the Annual Wellness Visit, he or she may be charged for those services. Expect to be charged the usual copay and deductible if the additional service is covered by Medicare. If your loved one receives any additional services not covered under Medicare, such as a routine hearing exam, then supplemental insurance will be responsible for 100% of its cost.
For more information about Medicare’s Annual Wellness Visit, these websites can help: