UCHealth: Does medicare cover preventive care?
Understanding Medicare coverage of preventive medicine, which focuses on promoting health and wellness and preventing illness and disease, is essential. As the population ages, preventive care and services like health screenings are especially important for older adults who face an increased risk for health issues.
Often concerned with cost, more than half of the nation’s seniors aren’t up to date with preventive care recommended by their doctor. But skipping these visits could come at the price of an individual’s health; effective treatment for illness and disease often depend on timely diagnosis.
The good news is some preventive screenings and services for adults 65 and older are covered by Medicare. The difference is how Medicare defines those preventive services isn’t the same as private insurance. For example, Medicare doesn’t cover annual “head to toe” physical examinations. Instead, benefits include an initial “welcome” preventive visit, followed by yearly wellness visits.
Before making appointments for preventive services, seniors should have a firm grasp on what is covered by Medicare so they know what services they are entitled to and what to expect. More details about what to expect and what is covered in the “Welcome to Medicare” preventive visit are available on Medicare’s website.
UCHealth Primary Care in Craig offers full service primary care, with same-day appointments available most days. Visit http://www.uchealth.org/craig to learn more and schedule an appointment online, or call 970.824.1020.
Does Medicare cover a preventive visit?
Medicare Part B enrollees are eligible for one “Welcome to Medicare” preventive visit within the first 12 months of their coverage. This is a once-a-lifetime visit, which may also be referred to as an Initial Preventive Physical Examination (IPPE). This visit is performed by your doctor and typically includes:
•Reviewing medical history (conditions, surgeries, medications).
•Checking blood pressure, height, weight, Body Mass Index (BMI) and vision (and possibly hearing).
•Screenings for any necessary disease prevention, as well as depression and personal safety.
•Administering any needed vaccinations.
•Discussing advance directives (a legal document for your health providers and loved ones documenting your health care wishes in case you are unable to make decisions).
Yearly wellness visit
After 12 months of Medicare coverage, individuals are eligible for a yearly wellness visit. The visit serves as a deeper dive into how an individual is functioning day-to-day physically and emotionally, and may also address planning for the future.
Patients should expect to spend time answering questions or completing assessments about their well-being and risk factors.
This visit can be performed by a doctor or a member of the clinic staff and typically entails:
•Creating or updating a personalized prevention plan.
•Screening for disease management (some recommended screenings may not be covered, so patients should first ask their provider about any out-of-pocket expenses).
•Assessing for memory, depression, mobility and fall risk.
More details about yearly wellness visits are available on Medicare’s website.
Remember, if you want to discuss any acute concerns during the wellness visit, make sure to mention that when you make the appointment so additional time is scheduled. You may be responsible for a co-pay or other charges.
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