Medicare does not cover annual physical exams, as dictated by the Social Security Act. However, there is a preventive service known as the Initial Preventive Physical Examination that is offered to those with Medicare. This service, often referred to as a “Welcome to Medicare” visit, includes a review of medical and social history, counseling on preventive services, and various health measurements such as height, weight, and blood pressure.
In addition to the Welcome to Medicare visit, Medicare also offers an annual wellness visit for beneficiaries. This visit does not include a physical examination but focuses on updating the personalized prevention plan. Components of the annual wellness visit include a review of medical and family history, health measurements, detection of any cognitive impairments, personalized health advice, and updating health risk factors.
Both the Welcome to Medicare visit and the annual wellness visit provide a plan for screenings, vaccinations, and other preventive services. These services may include flu and COVID vaccinations, mammograms, prostate cancer screenings, and colonoscopies. Most preventive services under Medicare are covered with no cost-sharing for beneficiaries, and a list of these services can be found on the Medicare website.
While Medicare does not cover annual physical exams, beneficiaries can still opt to have one at their own expense. Certain medical tests, such as an EKG or chest x-ray, may be covered by Part B if deemed medically necessary. Some Medicare Advantage plans may offer routine physical exams, but it is important for beneficiaries to verify coverage with their plan before proceeding with any services.
It is essential for beneficiaries to be aware of the coverage provided by Medicare and to double-check information before scheduling any medical services. While misinformation may exist online, it is crucial to confirm coverage details with Medicare or the individual’s insurance provider. By having a clear understanding of covered services and potential costs, beneficiaries can make informed decisions about their healthcare needs.
