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 health care 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.

You won’t pay anything for the visit if your doctor accepts Medicare assignment. The visit has coverage under Medicare Part B.

If your doctor performs tests or services that Medicare doesn’t cover outside of the preventive benefit, there may be out-of-pocket costs.

What is done during the Welcome to Medicare visit?

Medicare beneficiaries can expect a health care provider to review family health history, immunization records, screening tests, and more 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:

  • Screenings
  • 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 have end-of-life support plans made while you’re capable of making such decisions.

Also, your doctor provides you with a written plan letting you know about the shots, screenings, and other preventive services necessary.

When you make the appointment, tell the scheduling department that this appointment is going to 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 medications, supplements, and vitamins you take.

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” visit as well as your Annual Wellness Visit (AWV), neither of these is a requirement. Even though the visit isn’t mandatory, you’re highly 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 things like behavioral risk factors, activities of daily living, and more to better understand your health.

Lastly, a doctor will go over a checklist of preventive services you made need. 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 the most part, 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 better understand your financial responsibility.

If you anticipate having many doctor visits, a Medigap plan could make the most financial sense.

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 are meant to 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 provide you with a referral 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 if you have additional insurance, a copayment may be your only requirement.

What isn’t covered in the Welcome to Medicare visit

While there are plenty of screenings that take place during this initial visit, coverage isn’t available on everything. Medicare beneficiaries can expect the following services won’t have coverage:

  • Bloodwork
  • Diagnostics
  • Physical exams
  • X-Rays
  • 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 analysis of your health, but it’s more like a snapshot combined with a plan of action.

Who can perform the Initial Medicare Wellness Visit

There are several types of healthcare providers that 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 decide to discontinue coverage for audio-only telehealth when the Public Health Emergency ends. Any non-physicians have to 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 visit and the Annual Wellness Visit?

While both the Welcome to Medicare visit and the Annual Wellness Visit have similarities such as no cost to you and preventive screening coverage, these two appointments serve a different purposes. Also, both tests require you to see a doctor that accepts Medicare assignments.

The Initial Preventive Physical Exam is only done one time, and that 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 that are on a Medicare Advantage plan will need to see a doctor in their plan’s network to have coverage.

Also, anytime you change healthcare providers, it’s important to send updated medical records to the new office.

What should I bring with me to my Welcome to Medicare visit?

There are a few things you’ll want to have 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 your Medicare Advantage card. Although, if you have a Medigap plan, you’ll bring the Medicare ID as well as the 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 it easier to feel involved in your healthcare.

A few questions you may want to ask include:

  1. Are these things normal? When it comes to 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.
  2. 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.
  3. 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, this could include lifestyle suggestions or special dietary restrictions. The provider may even discuss specialist appointments you need to make to get a closer look at your current health.
  4. What important questions did I forget to ask? Asking if you’ve forgotten anything acts as a reminder for both you and your doctor. Physicians are only human after all, and asking this question gives you both the chance to ponder any missed topics of discussion.

FAQ’s

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 referrals to specialists 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, take a look at your current health, make a plan of action for any health issues, and get familiar with your care team. While this is a preventive visit, these types of visits are important because they lower 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 from 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, it’s best to choose someone that will accept Medicare, 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.

Give us a call at the number above to find the Medicare coverage that is best for you. Can’t call? No problem, just fill out an online plan comparison form to see the options in your area now.

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by Lindsay Malzone, Lindsay Malzone is the Medicare expert for Medigap.com. She's been contributing to many well-known publications as an industry expert since 2017. Her passion is educating Medicare beneficiaries on all their supplemental Medicare options so they can make an informed decision on their healthcare coverage.