Get the most from your Medicare Preventive Services
September 1, 2019
Many people are unaware of the many preventive services that are provided to Medicare beneficiaries without paying a single dollar in deductibles or co-pays. Preventive services are covered at 100% under your Medicare Part B benefits and are a great way to get started with utilizing your Part B benefits.
This is especially true if you are seeing a new primary care provider. You can begin accessing your preventive benefits by calling your primary care provider and making an appointment to have your “Welcome to Medicare Preventive Visit”. This visit can be scheduled anytime within the first 12 months that you have Part B. However after the 12 months elapses, it is no longer available. The purpose of this visit is establish a health baseline, to evaluate your need for the wide variety of 24 preventive services available and work with you to develop a personalized prevention plan. These services include screenings, testings and vaccinations that are designed to keep you healthy and to help discover problems early on when treatment is most effective.
The Welcome to Medicare Preventive Visit is not the same as an annual physical and it is important when making the appointment to use the correct terminology. At the appointment, your provider will review your records and determine in which order and how quickly the services should be scheduled. They may refer you to a different provider for some services such as a colonoscopy or a mammogram. Other services they will perform in the office, such as a depression screening or updating your vaccinations.
Your provider may ask you to complete a questionnaire to help assess your fall risk and determine the level of safety in your home. There is a limited physical exam provided as part of this visit. You can expect to have your height, weight, blood pressure, and balance checked, as well as a simple vision exam.
If 12 months have passed since your Medicare Part B became effective, and you did not take advantage of the Welcome to Medicare Preventive Visit, fear not. You can make an appointment every year for the Annual “Wellness” Visit (AWV). The AWV is also covered at 100% under Part B of Original Medicare. The goal of this visit is to create or update your personalized prevention plan. As indicated by the name, this visit can be accessed every year and gives you and your provider the opportunity to:
update your health risk assessment, prescription list and medical and family history
make current your list of medical providers and suppliers
screen for cognitive issues
provide health advice and make referrals to health education and/or preventive counseling services.
Health education and/or preventive counselling services are targeted at reducing identifiable heath risk factors and promoting general wellness. This can apply to weight loss, physical activity, cessation of smoking, nutrition, etc.
This is also the time to review and update your schedule of preventive services. The frequency of some screenings and tests may vary depending on your medical history and/or risk factors.
If during the course of your annual wellness visit a new or change in an existing condition is discovered, additional investigation may be needed through tests that may not be covered at 100%. Medicare covers medically necessary outpatient diagnostic tests at 80% after you have met the $185 deductible for 2019.
A complete list of preventive services is available at http://www.medicare.gov. If you have questions about attaining preventive services, call 1-800-Medicare or the state of Alaska Medicare Information Office at 1-800-478-6065.
Nila Morgan is a Certified Medicare Counselor who works at the Anchorage Senior Activity Center.