Yearly visits with your primary care physician serve as an integral part of health maintenance. Early detection and treatment of medical concerns can often prevent illnesses from progressing or leading to more serious complications.

Importance of Preventive Care

Monitoring your health on a yearly basis allows you and you doctor to record important vital health information. Keeping track of changes may help identify or predict health needs at a later date, especially as you age. Taking the appropriate steps to manage your health before you experience symptoms can delay complications, reverse the effects of chronic disease or prevent debilitating conditions from ever occurring.

Aside from yearly doctor’s visits to evaluate the status of your overall health and wellness, you may discuss lifestyle choices and get help making changes in tobacco use, frequent alcohol drinking consumption, or excessive intake of sugary or processed foods. Monitoring these habits carefully can reduce your risk of developing certain cancers, high cholesterol, diabetes, liver and kidney diseases and cardiovascular issues.

Your doctor may also advise you to exercise and may help you devise a personal exercise program that suits your mobility needs and personal goals. Additionally, health care professionals agree that sleep habits and activities that stimulate critical thinking skills also improve wellness and longevity.

Annual Physicals vs. Annual Wellness Visits – What’s the Difference?

Although many people assume an annual physical and annual wellness visit are the same thing, there are key differences between these two types of visits that you should understand as a Medicare recipient.

Both an annual physical and an annual wellness visit will involve measuring your height and weight as well as your blood pressure and body-mass index (BMI). Your doctor will also consult with you about any current medical conditions and those that are present in your family history. This may include discussing any medications or treatments you’ve received. An assessment of risk factors may also be performed in either visit.

In an annual physical, a doctor may examine your vital signs, head, neck, lungs and abdomen. They may also perform a neurological exam or a reflex test. Samples of urine and blood may be taken for further testing with a lab.

An annual wellness visit does not include these exams and tests, although the doctor may schedule a separate appointment or refer you to a specialist if they suspect underlying medical conditions that need more examination. They will also establish a schedule for necessary screenings during a wellness visit.

Medicare Coverage for Annual Wellness Visits

During your first 12 months as a recipient of Medicare benefits through Medicare Part B, you qualify for a one-time preventive visit known as your Welcome to Medicare visit. This is meant to establish the baseline for all future wellness visits with your primary care physician. When performed by a participating provider, this Welcome to Medicare visit is fully covered by your Medicare Part B benefits.

Annual wellness visits are also fully covered once every 12 months when provided by a physician who accepts assignment through your Medicare benefits. If your physician determines you need additional diagnostic screenings during your Welcome to Medicare visit or your annual wellness visits, you will be responsible for any cost-sharing obligations associated with these services under Part B.

Recipients who are eligible for both Medicare and Medicaid may be enrolled in savings programs that cover out-of-pocket expenses or enhance the type of health care services they can access. Eligibility for these programs are determined by needs-based rules that evaluate financial requirements and medical necessity. Your state’s Medicaid office will have information about application rules.

Medicare Supplemental plans, also known as Medigap plans, may also help reduce your out-of-pocket expenses when it comes to certain deductibles, coinsurance or copayment amounts. Medicare Advantage plans can also offer cost-sharing reductions as well as extra benefits, such as routine vision and dental care. These plans are offered through private insurance carriers and may not be available in all locations.

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