Ask the Provider about Medicare Wellness

BOYD HEALTHCARE SERVICES MEDICARE WELLNESS VISIT

 

 

                A Medicare Wellness visit is a FREE exam that is geared towards Health Risk Assessment of Individuals who are currently enrolled in Medicare Part A and B. This is divided into the Initial “Welcome to Medicare Exam” (IPPE) and the Annual Medicare Wellness Exam (AMW). This will be done by a team of Healthcare Professionals which will include Schedulers, Nurses, Medical Assistants, Billers, Nurse Practitioners, Physician Assistants and Physicians.

           

               A Medicare Wellness exam is not an annual physical exam.  Medicare does not cover an annual physical exam.

If risks are discovered, we will offer the services of Boyd Hospital or other facilities as per patient’s preference. An example of this is Physical Therapy for weakness' that can lead to falls or injuries.

 

Examples of screening tools recommended are as follows: 

Mammograms                        Pap Smears                Bone Density

         Colonoscopy               CVD risk labs              PSA                            

                 Lung Cancer screen (CT scan)                      Abdominal Aneurysm Screen      

     

 

Examples of risk factors are as follows:

Tobacco use               Alcohol use                 Illicit drugs                   Medications

         Frailty                          Malnutrition                 Depression                  Memory Impairment

              Vaccinations               Fall

 

 

                The goal of the exam is to determine the risks of each individual's developing Preventable Illnesses or Injuries. At the end of the visit, the patient will be handed a written recommendation pertaining to his or her risk.  An example of under diagnosed illnesses or risks are: Cardiovascular illnesses like Coronary Disease and Stroke, Diabetes, Depression, Cognitive Impairment (Dementia), Risk for falls, Risk for Preventable infections like Pneumonia (vaccinations) and Cancer screenings.

 

                It is well known that Greene County is an ever growing older community. Our community is rather underserved regarding these Preventable Exam Visits and Tests that are absolutely FREE. No deductible applies.  Patients of Boyd Healthcare services are encouraged to have the exam. We would like to extend these services to the rest of the community. Even if they are not currently our client. Patients who have Medicare Part A and B qualify for the visit.

 

 

               For patients who have a different Primary Care Provider, the visit is just a consultation.  We will not ask patients to become our regular clients. We will evaluate patients as per Medicare guidelines and will give written recommendations that patients can bring and discuss with their current Primary Care Provider.  

 

 

FREQUENTLY ASKED QUESTIONS:

 

What preventive medical visit does Medicare cover?

            Medicare pays for 2 wellness visits; a one-time Welcome to Medicare visit and an annual wellness visit.  Medicare does not pay for an annual general physical exam.

 

What is the difference between a Welcome to Medicare visit versus an annual Medicare Wellness visit?

           There are slight differences between the Initial Welcome to Medicare visit and the subsequent Annual Medicare Wellness.  Both visits includes an assessment of your health risk.

 

How often do I have to have a Medicare Wellness visit?

            In the first 12 months of enrollment, you will have a one time Welcome to Medicare visit.  Afterwards, you will have a subsequent Annual Medicare Wellness visit.

What happens during a Welcome to Medicare visit?

            During the visit to your provider, your general medical history will be recorded. Your height, weight, and blood pressure will be checked.  Your body mass index will be calculated as well.  You will receive a simple vision exam and probably a simple hearing exam.  Depending on your general health or medical history, further testing may be done or ordered.  At the end of the visit, you will receive a written recommendation pertaining to your health risk.

What should I bring to my visit?

            It is recommended that you bring all your medications including over-the-counter medications, a list of your previous medical and surgical history (hospitalizations), a list of your vaccinations, and a list of preventive testing that you have done in the past.  If you have an advanced directive or living will, please bring those with you to your visit.

           

Do I need to have a Welcome to Medicare visit before an Annual Wellness visit?

            No. It is not necessary.                     

 

Is there a deductible or co-pay for the Medicare Wellness Visit?

            No, there is no deductible or co-pay for either one.  Most of the recommended testing and referrals are done with no deductible as well.  Keeping in mind that if certain risk factors were identified, further testing or referral might have a deductible (20%) applied.

 

Is there an age limit for Medicare Wellness visit?

            No.  As long as you have Medicare part B, there will be no age limitations. Whether you are young or are advanced age (>80 yo)

 

Will I have out-of-pocket cost for preventive tests such as mammograms or colonoscopies?

            Medicare determines which preventive or screening tests are covered and when they should take place.  There will be no co-pay or deductible required for these exams.  A screening test is given to those who have no symptoms of a condition such as measuring cholesterol levels.  A diagnostic test is used to confirm a suspected condition once initial testing has revealed its possibility.  Medicare does cover a diabetic screening as well as cholesterol screening with no deductible.

 

I have a Medicare Advantage plan.  Do I qualify for Medicare Wellness visit?

            The answer is commonly yes.  Please call your Medicare Advantage representative to discuss this prior to visiting with the provider.  They would confirm or deny qualification.

 

I have a few more questions/concerns to ask.  Who do I call to obtain answers?

            Boyd Healthcare Services has designated personnel that would be happy to answer your questions pertaining to Medicare Wellness visits.  Please call (217) 942 6946 and ask for Donna Dewitt at ext. 1201.