Routine medical care is important when you’re sick or suffering from an ailment, but what about when you’re feeling fine? The truth is, scheduling an annual doctor’s visit to assess your health, often referred to as a wellness visit, is just as important to do when you’re feeling fine as it is when you’re feeling under the weather. These visits provide your physician the chance to discuss any healthcare concerns you may have, and they also give you the opportunity to ask questions about any medications or supplements you’re taking or about changes to your diet or exercise routine.
The Difference Between a Physical and a Wellness Visit
For many people, the terms “physical” and wellness visit” are used interchangeably, but they are actually quite different. During a physical, your doctor carries out a physical exam of your major systems, takes measurements, documents any changes and reviews concerns. During a wellness visit, there is typically no examination that takes place other than a general inspection of the body. A wellness visit is more like checking in with your doctor while a physical is more like an in-depth examination to assess body systems and functions. During a wellness visit, you may bring up a medical concern which prompts a physical exam, and during a physical, you may discuss wellness concerns, but the two are billed as separate types of visits.
What Does a Medicare Wellness Visit Include?
Fortunately for Medicare recipients, an annual wellness visit is included with Part B coverage. During a wellness visit under Medicare, patients will have the chance to discuss any changes to existing conditions that have previously been documented, and the physician will review medical history to ensure that the patient is still in need of any prescribed medications. A doctor may also provide the patient with a preventive health plan designed to encourage healthy lifestyle choices. This plan may detail dietary changes or weight loss exercises, smoking or alcohol cessation information, a list of support groups or therapeutic care providers and more.
While wellness visits usually do not include any type of treatment in the doctor’s office unless an emergency occurs, patients are often directed to make a follow-up appointment for further screening if the wellness visit brings to light concerns that need to be addressed in detail. Keep in mind that this follow-up visit will not be covered as a wellness visit under Medicare and will be billed as a regular outpatient visit.
Additionally, a cognitive assessment is typically performed during the wellness visit, but this is usually done simply by conversing in the office. Finally, patients will fill out a wellness questionnaire while waiting to see the doctor, and the answers will be assessed to ensure that the doctor is able to address any symptoms that are deemed problematic that may not have been expressed directly by the patient.
Medicare Coverage Beyond Wellness Visits
If further medical treatment is required subsequent to a wellness visit, the good news is that Medicare provides a range of coverage options in the forms of inpatient, outpatient and prescription drug benefits. Medicare Part A covers things like inpatient hospitalization and skilled nursing care, and Medicare Part B provides coverage for outpatient care when it comes to doctor’s visits and treatments at clinics or testing at a lab. Medicare Part D is the prescription drug benefit and covers most medications that can be purchased at a retail pharmacy to be administered at home.
If you’re unsure as to your benefits or you’re considering Medicare in the future and would like to know more about your options, contact your current plan and/or research your options to find the Medicare coverage that will meet your needs.
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Do Medicare Advantage Plans Cover Wellness Exams?(Opens in a new browser tab)