Are you a Medicare beneficiary? Is your spouse, your parent, or another elderly loved one on Medicare? If the answer is YES, 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.
“If you’ve had Medicare Part B (Medical Insurance) for longer than 12 months, you can this Wellness Visit once every 12 months to develop or update a personalized prevention plan to help prevent disease and disability, based on your current health and risk factors,” said Joshua Hunter, one of the public benefits specialists at Takacs McGinnis Elder Care Law, a Life Care Planning Law Firm in Hendersonville, Tennessee. “This visit isn’t a physical exam as much as it is an action planning session with the goal of prevention.”
It’s important to note that The Medicare Annual Wellness Visit is not mandatory. “You can take advantage of these visits for free once per year, but if you decide not to make an appointment for this visit, you won’t lose your Medicare benefits,” Joshua noted.
What happens during the Annual Wellness Visit? First, your provider will ask you to fill out a questionnaire, called a “Health Risk Assessment.” Answering these questions helps the Medicare beneficiary and the provider develop a personalized prevention plan to stay healthy. 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. Learn more about preventative and screening services.
- Advance care planning
During the Annual Wellness Visit, the provider will also perform a cognitive assessment to look for signs of dementia, including Alzheimer’s disease. Signs of cognitive impairment include trouble remembering, learning new things, concentrating, managing finances, and making decisions about everyday life. If the provider suspects cognitive impairment, Medicare covers a separate visit to do a more thorough review of cognitive function and check for conditions like dementia, depression, anxiety, or delirium.
Who pays for the Annual Wellness Visit? “Original Medicare covers the whole thing with no coinsurance or deductible if your loved one sees health care providers who accept the Medicare-approved amount in full,” Joshua explained. “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.”
Keep in mind that 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 Annual Wellness Visit, and if these additional tests or services aren't covered under the preventive benefits. If you or 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.
Many Life Care Planning Law Firms employ Medicare experts like Joshua who can help you make the most of these important benefits. Find a Life Care Planning Law Firm near you.