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Key Takeaways
- Seniors on Medicare should pay close attention to what kind of visit they have with their primary care physician to make sure it’s covered.
- Unlike traditional health insurance, Medicare Part B doesn’t cover annual physicals.
New to Medicare? Knowing the difference between a wellness visit and a routine physical exam could save you a lot of money.
Medicare Part B insurance—which helps cover preventative and medically necessary services—offers yearly wellness visits at no cost to patients.
Unlike traditional insurance, which typically covers annual preventative care, routine physical exams are not covered by Medicare Part B, so a patient must pay 100% of the cost.
Different Kinds of Appointments
Medicare draws an important distinction between wellness visits and routine physical exams.
During a wellness visit, a doctor will review your medical history, gather information on your lifestyle, take certain measurements, provide guidance on when to receive screenings, and more.
A routine physical exam, on the other hand, is typically more involved: physicians may order blood tests and listen to your heart and lungs.
To ensure your wellness visit is covered, stick to what is typically included in the visit. Asking questions about your recurrent hip pain or an upset stomach could result in the physician adding another medical billing code to the visit, meaning you may be on the hook for an additional bill.
And when you’re booking your appointment, make sure to specify that you want a wellness visit.
You should also be strategic when scheduling these visits.
These visits are only covered once every 12 months. Plus, you must wait for at least 12 months after you enroll in Medicare Part B or after you have your “Welcome To Medicare” preventive visit before you have a wellness visit.
