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Medicare Check-Ups Explained

A Look at Wellness Visits

For people over sixty-five, Medicare covers a wellness visit once every twelve months if you have Medicare Part B. These are commonly referred to as annual wellness visits. The goal of the visit is to identify what is needed to help you become and stay well.

There are three names for annual wellness visits: the welcome to Medicare visit, initial annual wellness visit, and the subsequent annual wellness visit. They share many similarities, yet have some subtle differences. 

All three visits are conversational and do not include any physical examination by the medical provider. Medicare does not cover what most people think of as a complete physical exam. The nurse or provider will usually ask you various sets of questions and may have you complete small tasks. Depending on your doctor’s office, you may answer the questions verbally, on a paper form, or in a computer system. Your provider will use the answers to the questions to recognize gaps in your healthcare, assess your risk for certain conditions, and identify unmet medical needs. Additionally, you and your provider may choose to discuss other medical topics, such as hypertension, COPD, or a new sinus infection. This can happen at the same visit, but is not covered as a part of the annual wellness visit. 

Welcome to Medicare Visit 

This visit is covered only once and must happen within the first twelve months that you have Medicare Part B. If you missed getting your welcome visit, do not worry. You will start with an initial visit, as described below. As part of the welcome visit, you will have an electrocardiogram (EKG) and have your vision checked. There may be more attention paid to your food choices and physical activity during this conversation compared to later visits. 

Additionally, at the welcome visit, you will create a foundation of information that can be built upon each year. Along with your medical provider, you will review and update your medical history including: prior medical conditions, surgeries, hospital stays, allergies, and family medical history. Also, be prepared to review all current prescribed medications, over-the-
counter medications, vitamins, and supplements you take. Even though there is no required physical exam at the welcome to Medicare visit, you will have your blood pressure, height, and weight measured. Your body mass index (BMI) will also be calculated based on your height and weight. Your provider will review your ability to complete common daily tasks, like getting dressed and taking a shower. Because depression can occur at any age, this evaluation will happen during your visit as well. The provider will also consider your hearing, your safety, and how likely you are to fall. 

Each type of visit will include the opportunity to discuss advance care planning. Advance care planning is all about planning for your medical future, particularly planning for anytime that you may not be able to speak for yourself. Your provider may offer you resources to document your desires, such as a medical directive form.

Healthcare maintenance is another fundamental portion of your visit. Healthcare maintenance helps prevent disease, through actions like cancer screening and vaccinations. You can learn when these items are due for you at this visit. 

Initial Annual Wellness Visit 

The content differs slightly from the welcome to Medicare visit. You can schedule this visit twelve months after your welcome visit. You and your provider will review and update the topics of the welcome visit. Your provider will also evaluate your memory.
You will be asked about your ability to complete common activities like housekeeping and taking medication. You will get the opportunity to make sure your provider is aware of all of your specialists. This visit still includes a review of your healthcare maintenance, health risks, and the opportunity to discuss advance care planning. 

Subsequent Annual Wellness Visit 

Think of this visit as an update to the initial annual wellness visit. This can be done every twelve months, and during the visit, you will review your history and make updates from the last year. 

At the end of each of the various visits, you and your provider will have a strong idea of your health needs. You can get referrals from your provider, as well as education and resources to help meet those needs. For example, some people may uncover the need to see an eye doctor, start physical therapy, or have a colonoscopy. 

Now that you know what to expect, you may be thinking, What can I do to be prepared? I recommend collecting the information outlined below and bringing it to your appointment. 

• medications and supplements
• names of other providers (GI doctor, heart doctor, etc.)
• medical suppliers (oxygen supplier, etc.)
• prior and current medical problems, including allergies
• family medical history
• immunization record
• previous colonoscopies or mammograms
• any questions you have! 

You might also consider bringing a family member or trusted friend along as a health advocate. 

Taking advantage of these Medicare wellness visits is an important way to stay on top of your health. Be well! 

Claire W. Thomas, MD, is a family physician who provides primary care to adult and pediatric patients at Commonwealth Primary Care. She is a native of the metro Richmond area. She earned her Bachelor of Arts and Doctorate of Medicine from the University of Virginia, then completed her Family Medicine Residency at the University of North Carolina at Chapel Hill. Outside of work, she enjoys working on art projects, researching family history, trying local restaurants, and spending time with family.
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