Medicare and Medicare Advantage patients need to be aware of some special circumstances that relate to their care.
External websites
Medicare.gov - is the best source for all matters that relate to Medicare.
Does Medicare pay for a routine physical?
No. Medicare does not pay for preventive physical examinations. You may want to review Medicare benefits by accessing: MyMedicare.gov or reviewing your “Medicare and You” handbook.
How are Welcome to Medicare and Annual Wellness Visit different from a routine physical?
- The Welcome to Medicare visit is a one-time only Medicare covered benefit and is intended to establish wellness care. The visit does not include a physical exam. Patients are eligible to receive this service during their first year of Medicare Part B coverage.
- The purpose of the Annual Wellness Visit is to discuss health promotion and wellness. Patients are eligible to receive this service during their second year of Medicare Part B coverage and every year following. The visit does not include a physical exam and is not intended to evaluate or manage problems or chronic conditions. This visit is a Medicare covered benefit.
- A yearly physical (Preventive Care Visit) is a service provided when you are in good health to evaluate and maintain your health. The exam includes age and gender appropriate lifestyle changes. Vaccinations may be discussed or given. Screening or lab test may be ordered to detect early signs of disease. This exam is not a Medicare covered benefit.
Do I need to have a Welcome To Medicare exam before an Annual Wellness Visit?
No, the Welcome to Medicare Visit is not required prior to the Annual Wellness Visit.
Does Medicare cover any other type of doctor’s exams?
Office visits are covered by Medicare and are problem focused. Office visits are scheduled for patients who are experiencing new or existing medical conditions. Office visits may be subject to cost-sharing for the patient, such as a copayment.
Does Medicare cover the Zoster vaccine?
The Zoster vaccine may be covered under your Part D prescription plan. You will want to contact your Part D prescription plan for further information.
Where do I find Medicare benefit information?
You may want to review Medicare benefits by accessing: MyMedicare.gov or reviewing your “Medicare and You” handbook.
