Annual wellness visit vs. annual physical visit

WHAT'S THE DIFFERENCE?

Question: Why did I get a bill for my annual physical? I thought Medicare covered that.

Answer: Medicare covers annual wellness visits, not annual physicals.

Question: What is the difference?

Answer: Annual wellness checkups include a review of: 1. Health history.

2. Routine measurements like, weight, height, blood pressure.

3. Review of current prescriptions.

4. Appropriate preventative services like vaccinations, mammograms, colonoscopies.

5. Possible cognitive assessments for signs of dementia and Alzheimer’s.

6. Advanced care planning like an advanced directive.

7. The doctor may also ask about living environments, access to food, family status etc.

Question: Then what is an annual physical?

Answer: Physical exams involve an exam where the doctor touches the patient, obtains blood work or runs diagnostic tests. Medicare Part B does cover “medically necessary” clinical diagnostic and laboratory tests when the doctor orders them at an annual physical, but not the cost of the annual physical, unless otherwise stated by the insurance company. These tests may include blood tests, urinalysis, certain tests on tissue specimen and some screening tests.

These tests may have a deductible or co-payment. Patients should check with their health insurance for these costs. Some Medicare Advantage Plans allow a wellness check up to be combined with an annual physical. This comprehensive service is an additional benefit not covered by Original Medicare and includes a head-to-toe exam.

The purpose of this exam is to screen for disease, promote a healthy lifestyle and assess a patient’s potential risk factors for future medical problems.

Bottom line: Those who haven’t had their annual wellness checkup should call their primary care doctors office and make one. These wellness checkups can help make sure people are taking a preventative approach to their healthcare.

For questions or more information on Medicare plans, call Medicare insurance broker Sandra Teel at 657-204-4224 or email steelmedagent@gmail. com.

—Sandra Teel