The Welcome to Medicare visit will likely be your first doctor visit Medicare covers. This initial visit requires no copay from you and is usually done by a primary care doctor. Your healthcare provider will use this visit to track and improve your health as medically necessary. A personal health plan is made for you at this visit.
Below we’ll discuss more in-depth details of your Welcome to Medicare visit.
Your Welcome to Medicare Visit
Beneficiaries new to Original Medicare are eligible for their initial preventive physical exam (IPPE). The visit isn’t meant to be an intense physical exam but rather a plan to prevent a decline in health.
If your doctor accepts the Medicare assignment, you won’t pay anything for the visit. The visit has coverage under Medicare Part B.
There may be out-of-pocket costs if your doctor performs tests or services that Medicare doesn’t cover outside of the preventive benefit.
What is done during the Welcome to Medicare visit?
Medicare beneficiaries can expect a healthcare provider to review family health history, immunization records, and screening tests to ensure a prevention plan is aligned with their needs. The checkup will help to ensure your healthcare is aligned with your needs.
The visit will include a review of your social and medical history. Your doctor will also give you information on preventive services such as:
- Flu shots
- Body Mass Index (BMI) calculations
- A review of potential risk factors
You can expect your doctor to talk with you about advance directives. It’s important to make end-of-life support plans while you can make such decisions.
Also, your doctor provides a written plan informing you about the necessary shots, screenings, and other preventive services.
When you make the appointment, tell the scheduling department that this appointment will be your “Welcome to Medicare” visit. To best prepare for the visit, bring your medical records, family health history information, and a list of all your medications, supplements, and vitamins.
The “Welcome to Medicare” visit isn’t the same as the “Annual Wellness Visit,” and it’s not physical. Instead, the visit is meant to review possible health conditions and take preventive care measures.
Do I have to do a Welcome to Medicare visit?
While Medicare Part B covers your “Welcome to Medicare” and Annual Wellness Visit (AWV), neither requirement is required. Even though the visit isn’t mandatory, you’re encouraged to take advantage of the Medicare wellness visit.
Regular visits with your doctor are important because you need to discuss things like social history, pneumococcal vaccinations, blood pressure, and mental health.
Further, a healthcare provider will discuss behavioral risk factors, activities of daily living, and more to better understand your health.
Lastly, a doctor will review a checklist of preventive services you needed. These things can include screenings for:
- Glaucoma check
- Cancer screenings
- Medical Nutritional Therapy
- Smoking cessation counseling
- Diabetes self-management training
- Bone Mass Measurements
- Immunizations, and more.
For most, preventive services don’t have a copayment or coinsurance. However, diagnostic tests could require an out-of-pocket payment. Talk to the doctor’s office about services rendered to understand your financial responsibility better.
A Medigap plan could make the most financial sense if you anticipate having many doctor visits.
Does the Welcome to Medicare visit include bloodwork
Since a wellness visit won’t include bloodwork. When you schedule a diagnostic test, that’s when you can expect bloodwork to take place.
Your wellness visits check routine things such as BMI and blood pressure. Also, the healthcare provider will discuss your health risks, potentially scheduling you for another appointment that includes more in-depth testing.
Is an EKG required for the Welcome to Medicare visit
No, an EKG is not required as part of the visit. However, your doctor may suggest an electrocardiogram and refer you to a specialist.
Medicare covers screenings for most diagnostic tests if you get a referral from a doctor. An EKG and ECG are both diagnostic tests. Your initial exam will determine if you need further testing.
Although, you may pay the Part B deductible and coinsurance for further diagnostic testing. But a copayment may be your only requirement if you have additional insurance.
What isn’t covered in the Welcome to Medicare visit
While plenty of screenings occur during this initial visit, coverage isn’t available on everything. Medicare beneficiaries can expect the following services won’t have coverage:
- Physical exams
- Wound care
- New health concerns
When you schedule this visit, verify with the doctor’s office that this appointment is NOT a physical, Medicare won’t cover routine physicals. An initial preventive physical exam sounds like a thorough health analysis, but it’s more like a snapshot combined with a plan of action.
Who can perform the Initial Medicare Wellness Visit
Several healthcare providers can see you for the initial preventive physical exam. Physicians, Physician assistants, Nurse Practitioners, and Certified Clinical Nurse Specialists can all provide care for this exam.
Medicare may discontinue audio-only telehealth coverage when the Public Health Emergency ends. Any non-physicians must be legally authorized and eligible to provide a Wellness visit in the state for coverage to be applicable.
What is the difference between the Welcome to Medicare and the Annual Wellness Visit?
While both the Welcome to Medicare and the Annual Wellness Visit have similarities, such as no cost to you and preventive screening coverage, these two appointments serve different purposes. Also, both tests require you to see a doctor that accepts Medicare assignments.
The Initial Preventive Physical Exam is only done once and takes place within the first 12 months of your Part B effective date.
After your initial appointment, when you’ve had Part B for over a year, those checkups will be called the Annual Wellness Visit.
Neither of these appointments is required, but they help you manage your health and become familiar with your care team should your health decline.
How to schedule an Initial Medicare Wellness appointment
Scheduling your Initial Preventive Physical Examination is simple and can be done over the phone. As soon as you have your Part B effective date, you can call your primary care provider and request an appointment date that aligns with your Medicare coverage start date.
Beneficiaries on a Medicare Advantage plan must see a doctor in their network to have coverage.
Also, you must send updated medical records to the new office anytime you change healthcare providers.
What should I bring with me to my Welcome to Medicare visit?
You’ll want to have a few things handy when you meet with your doctor for this visit.
Some things you may want to bring with you include:
- A complete list of your medications, both over-the-counter and prescription drugs
- Medical record history that includes any lab reports or x-rays
- Immunization or vaccination records
- Family health history about the information on hereditary conditions
- If you have an advanced directive or end-of-life health-decision making documents
Some other things you may want to consider bringing; it can be beneficial to make a list of questions to ask your provider and bring it to the visit.
Also, don’t forget you’ll need your red, white, and blue Medicare ID card or Medicare Advantage card. Although, if you have a Medigap plan, you’ll bring the Medicare and Medigap ID.
Those that struggle to remember everything from the appointment should consider bringing a friend or family member to take notes and write down any information necessary for following appointments.
Now, if nobody can go with you, asking your doctor to help make sure you have adequate notes is perfectly acceptable.
What questions should I ask at my Medicare Wellness Visit?
Sometimes it’s hard to know which questions to ask your doctor. Having a notebook with a list can make feeling involved in your healthcare easier.
A few questions you may want to ask include:
- Are these things normal? Regarding your health, bringing up sensitive topics with your doctor is important. Don’t be afraid to ask questions to the person that can help you. You may want to ask about libido, menopause, sleep schedule, blood pressure, or bowel movements.
- Does my family health history put me at risk? Family health issues can change, and any new issues must be brought up in your conversation with the doctor. Asking if new information changes your risk factors gives you a better understanding of your health.
- What do I need to do next? Your doctor will take the time to talk about things you should implement into your life to stay healthy, including lifestyle suggestions or special dietary restrictions. The provider may even discuss specialist appointments you need to make to get a closer look at your health.
- What important questions did I forget to ask? Asking if you’ve forgotten anything is a reminder for you and your doctor. Physicians are only human, and asking this question allows you to ponder any missed discussion topics.
How long does it take for the results of the Medicare Wellness Visit to be reported?
Any necessary referrals will be given to you at the initial visit. But results from diagnostic tests will vary depending on the type of test done. Talk to your specialist or the lab where testing takes place to find a result timeline.
Is clinical lab testing part of the Initial Preventive Physical Exam?
No, the initial Medicare visit won’t include a clinical lab test. Instead, this visit will provide you with specialist referrals for diagnostic testing.
Can the Welcome to Medicare visit be done virtually?
Yes, Medicare wellness visits can be done virtually because they are on the list of approved telemedicine services. Medicare beneficiaries may even use audio-only services to complete the annual wellness appointment. Any necessary follow-up visits, such as specialist visits, may require you to attend an in-person appointment.
What is Welcome to Medicare Visit for?
The purpose of the Welcome to Medicare visit is to get to know your doctor, look at your current health, plan for any health issues, and get familiar with your care team. While this is a preventive visit, it is important because it lowers your risk of hospitalization and a delayed diagnosis. If you haven’t had a wellness visit, consider contacting your doctor as soon as possible to get your health plan in place.
How long does the Medicare Wellness visit take?
The visit with your healthcare provider can take half an hour up to a full hour. But if the primary care doctor needs to run additional tests, the visit may take longer. You can expect a visit like this annually.
Will Medicare require me to have a primary care physician?
It’s suggested that you have a primary care doctor, but it’s not mandatory. When you select a doctor, choosing someone who will accept Medicare is best. This ensures you have coverage when you see them.
How Can Medicare Supplemental Insurance Help After Your Welcome to Medicare Visit?
Medicare beneficiaries could obtain referrals from the initial visit. There are almost always costs associated with seeing a specialist. Medigap plans can help cover the coinsurance or copays Medicare would otherwise leave you to pay.
Medicare Advantage plans are another coverage option that can help keep costs lower than Original Medicare.
Any agent will highly recommend enrollment into a policy because medical costs can be so high. You owe it to yourself to have quality Medicare coverage.
Let us give you the tools to choose the most suitable policy for your situation. Eligibility can be one of the most challenging things to understand with Medicare, and we love to find ways to help.
Call us at the number above to find the best Medicare coverage. Can’t call? No problem, just fill out an online plan comparison form to see the options in your area now.