Riverside Believes in Wellness at Any Age – Now, so Does Medicare.
Effective January 1, 2011 Medicare began covering an Annual Wellness Visit with your primary care provider. And, there are no co pays or deductibles for this visit.
Your first Annual Wellness Visit will include, among other things, a medical history, health risk assessment and an evaluation of physical condition and screening for cognitive impairment. In addition, your doctor will work with you to set a prevention plan, including appropriate health screenings. If after your visit, your doctor determines additional testing is necessary, there may be a fee associated with some services.
The Annual Wellness Visit is not an annual physical, nor should it be confused with the Welcome to Medicare Visit – a one-time visit for patients new to Medicare.
Your doctor should be someone who knows you as a person, not just a sick person. The Annual Wellness Visit is a strategy session designed to help you and your doctor develop an ongoing health plan intended to keep you healthy, safe and independent for a long time.
Frequently Asked Questions
1. What does the Annual Wellness Visit cost?
You pay nothing out of pocket for this visit. However, you may incur a copay or deductible expense if additional testing is required.
2. When am I eligible for my Annual Wellness Visit?
After you have had Medicare Part B for more than 12 months. If you've had a "Welcome to Medicare Visit" within the last 12 months, you must wait 12 months to schedule your Annual Wellness Visit.
3. What if I'm sick? Can I schedule my sick visit and Annual Wellness Visit at the same time?
It will depend on the severity of the illness and your doctor's schedule but may be possible. However, you will be charged for a sick visit at that time.
4. How often can I have my Annual Wellness Visit?
You may have an Annual Wellness Visit once every 12 months.
5. What is covered during the new Annual Wellness Visit?
Your first Annual Wellness Visit will include:
- routine measurements such as height, weight, blood pressure and body-mass index;
- review of medical and family history;
- establishing a list of current providers, suppliers, and medications;
- a personal risk assessment (including any mental health conditions);
- a review of functional ability and level of safety;
- detection of any cognitive impairment;
- screening for depression;
- establishing a schedule for Medicare's screening and preventive services you qualify for over the next 5 to 10 years;
- other advice or referral services that may help intervene and treat potential health risks;
- voluntary advanced care planning.
Subsequent Annual Wellness Visits will include:
- measurement of weight, blood pressure, and other measurements deemed appropriate;
- an update to medical and family history;
- an update to the list of providers, suppliers, and medications;
- a review of the initial personal risk assessment;
- detection of any cognitive impairment;
- an updated screening schedule; and,
- a review and update to list of referral services to help intervene and treat potential health risks.
6. Is the Annual Wellness Visit the same thing as an annual physical exam?
No. An annual physical is a much more extensive physical examination. In addition to collecting a medical history, it may also include: Vital signs check, lung exam, head and neck exam, abdominal exam, neurological exam, dermatological exam, and extremities exam. The Annual Wellness Visit should not replace your annual physical.
7.Will I actually see a doctor during the Annual Wellness Visit?
You will see your primary care provider which could be a physician, nurse practitioner or physician assistant. However, most of your time may be spent with an allied health profession, such as a nurse or medical assistant who will gather most of your medical history so that your physician can determine an appropriate preventive health screening plan.
8. What is the difference between the "Welcome to Medicare Visit" and the "Annual Wellness Visit?"
- Medicare covers a ONE-TIME Welcome to Medicare Visit. (See below for what your provider will cover at this visit.)
- Medicare also covers an ANNUAL WELLNESS VISIT every 12 months (See above for what your provider will cover during this visit).
9. When am I eligible for my "Welcome to Medicare Visit?"
Medicare covers a one-time "Welcome to Medicare Visit" within the first 12 months you have Medicare Part B. If you did not receive your Welcome to Medicare Visit and have been with Medicare for more than 12 months, you are eligible for your Annual Wellness Visit.
10. What does the Welcome to Medicare Visit cost?
Beginning January 2011, you pay nothing out of pocket for this visit.
11. What is covered in the "Welcome to Medicare Visit?"
A Welcome to Medicare Visit is similar to the Annual Wellness Visit and includes the following:
- A thorough review of health, education and counseling about the preventive services covered by Medicare and referrals for other care if needed.
- Establishing a schedule for Medicare's screening and preventive services you qualify for over the next 5 to 10 years.
- A review of a medical and social history with attention to risk factors for disease detection.
- A review of an individual's potential for depression or other mood disorders.
- A review of the individual's functional ability and level of safety.
- An examination to include an individual's height, weight, blood pressure, visual acuity screen, measurement of body mass index and other factors as deemed appropriate by the examining physician or qualified non-physician practitioner.
- End-of-life planning, upon an individual's consent.
- Education, counseling, and referral based on the results of the review and evaluation services described in the previous five components.
- EKG with interpretation and report.
- Hearing assessment.
12. Do I have to have my Welcome to Medicare Visit before my Annual Wellness Visit?
You don't have to have a "Welcome to Medicare" visit before getting an Annual Wellness Visit, but if you choose to have the Welcome to Medicare Visit, you'll have to wait 12 months before you can have your first Annual Wellness Visit.
13. What if I require further tests or screenings?
Medicare covers many screenings for people who are at high risk for certain diseases. During your Annual Wellness Visit, you and your doctor will decide on the appropriate tests and screenings.
14. How do I schedule my Annual Wellness Visit or my Welcome to Medicare Visit?
To help schedule your Welcome to Medicare visit or determine when you become eligible for your first Medicare Annual Wellness Visit, call (757) 875-7880 or toll free at (800) 675-6368, Option 3.