Here’s some good news. Everyone covered under Medicare Part B is eligible for a free annual wellness checkup conducted by a doctor or another health care professional.
Medicare & You 2017, the official Medicare handbook, says that “Medicare covers two types of exams — one when you’re new to Medicare and one each year after that.” These exams are the initial “Welcome to Medicare” preventative exam and a yearly “Wellness Exam”.
According to the official Medicare website, www.medicare.gov, you get the “Welcome to Medicare” preventive visit “only within the first 12 months you have Part B. This visit includes a review of your medical and social history related to your health and education and counseling about preventive services, including certain screenings, shots, and referrals for other care, if needed.”
If you’ve had Part B for longer than 12 months, you’re eligible for the yearly “Wellness Exam.” During a wellness visit, your doctor will measure your height, weight, body mass, and blood pressure — and perhaps listen to your heart. Medicare.gov says “You can get this visit to develop or update a personalized prevention help plan to prevent disease and disability based on your current health and risk factors. Your provider will ask you to fill out a questionnaire, called a ‘Health Risk Assessment’ as part of this visit. Answering these questions can help you and your provider develop a personalized prevention plan to help you stay healthy and get the most out of your visit. This visit is covered once every 12 months (11 full months must have passed since the last visit).” You don’t have to have a “Welcome to Medicare” visit before getting an annual “Wellness Exam.”
But – and this is important –do not confuse these wellness exams with a physical, which is more extensive. In order to receive the Wellness Exam, you cannot just ask your doctor’s office for a physical. To get the free Medicare “Wellness Exam,” you must ask your doctor’s office for it by name. (The Medicare billing code is G0438). Your doctor must agree to accept Medicare’s payment as the payment in full for the service, so ask about this, too. If you’d prefer to have a physical exam, you will have to pay the cost out of your own pocket unless you are covered by secondary insurance.