Does Medicare Cover an Annual Physical?

Medicare does not cover an annual physical exam in the same way that private health insurance might. However, Medicare does offer a couple of related preventive services:

1. "Welcome to Medicare" Preventive Visit

• When: This is available to new Medicare beneficiaries within the first 12 months of enrolling in Part B.

• What It Includes: A review of your medical and social history related to your health, certain screenings, shots, and referrals for other care if needed.

• Cost: Generally, there is no cost if the doctor or other qualified health care provider accepts assignment.

2. Yearly "Wellness" Visit

• When: This can be received once every 12 months after you've had Part B for more than 12 months.

• What It Includes: A health risk assessment, a review of your current providers and prescriptions, height, weight, blood pressure measurements, and personalized health advice. It may also include a screening schedule for appropriate preventive services.

• Cost: Typically, there is no cost if the doctor or other qualified health care provider accepts assignment.

Differences from a Traditional Physical

• Traditional Physical: Often more comprehensive, including a full head-to-toe examination, blood tests, and other detailed evaluations.

• Medicare Visits: Focus on preventive care, health assessments, and planning rather than the extensive tests and evaluations of a traditional physical.

Additional Covered Preventive Services

Medicare Part B also covers various preventive services at no cost if you meet eligibility criteria, including:

• Screenings for cardiovascular disease, diabetes, and certain cancers.

• Immunizations like flu shots, pneumococcal shots, and hepatitis B shots.

• Counseling services such as tobacco cessation counseling.

Costs and Providers

• Providers: Ensure that your doctor or healthcare provider accepts Medicare assignment to avoid unexpected costs.

• Additional Costs: If additional tests or services are performed that are not part of the preventive visit, you might have to pay coinsurance or deductibles.

For detailed information and to ensure you're getting the most from your Medicare coverage, you can call me and happy to have a conversation of what is included in your coverage. Lisa Maas 208-544-5011