Preventative Annual Wellness Visit

Now’s the time to get the most out of your Medicare Insurance

The best way to stay healthy is to live a healthy lifestyle. You can live a healthy lifestyle and prevent disease by exercising, eating well, keeping a healthy weight, and not smoking. 80% of all chronic illnesses and diseases can be prevented by proper exercise, a healthy diet, quality sleep, avoidance of tobacco, moderation of alcohol, and positive human relationships.

Medicare can help. Medicare pays for many preventive services to keep you healthy. Preventive services can find health problems early when treatment works best and save you from getting certain diseases. Preventive services include exams, shots, lab tests, and screenings. They also include programs for health monitoring, counseling, and education to help you take care of your health.

Medicare and your insurance company waive all deductible and co-pay costs for your Annual Wellness Visit as well as the other recommended screening tests, treatments, and counseling. Therefore you ought to take advantage of the zero cost service annually every 365 days. It would be best if you took responsibility for your health.

The Annual Wellness Visit is not the classic Annual Physical. Exam. Instead, it is a checklist of sorts regarding the various preventive services that you have had or that should be recommended and ordered if appropriate. Medicare usually will not reimburse the clinic if acute or chronic illness services are provided the same day as a Wellness Visit.

The Preventive Annual Wellness Exam office visit is an excellent means to avail yourself of no-cost services such as Immunizations for influenza, streptococcus pneumonia, hepatitis B. (Zoster (Shingles) immunization is not covered.) Periodic screening tests are no cost such as Colonoscopies, DEXA bone density tests, Mammography, PAP tests, Sexually Transmitted Diseases (HIV, Chlamydia, Gonorrhea, Syphilis, Hepatitis B & C), Lipid screening tests and Diabetes screening tests. When indicated, there is no-cost counseling for Depression, Alcohol misuse, Tobacco, Obesity, Diabetes, Cardiovascular risk reduction, and Nutrition. When calling for the appointment, specify it is for the Preventive Annual Wellness Exam. It typically does not include a Physical Exam, but some policies cover a no-cost head-to-toe exam as a separate visit once a year. When calling for the appointment, specify it is for the covered Annual Physical Exam.

See the Web Page "Documentation of a Wellness Visit" to see what information should be collected at the Annual Wellness Visit.

To get the most value out of your Wellness Visit, Estate Financial Services has put together various documents that would be wise to open, complete, save, and print to paper. The reports have embedded logic in them to give you and your doctor an interpretation. They provide 95% of the information your provider needs to complete the Wellness Visit and leave more face-to-face time to discuss what should be done to improve and maintain well-health. You may download the PDF documents at the bottom of this page.

When Scheduling with your Doctor

When calling your doctor's office, please request the appointment using the words "Preventative Annual Wellness Visit." You may also let them know it is an Evaluation and Management Level 4 visit, which should allow at least 40 minutes of face-to-face time with your doctor. Your last Annual Wellness Visit must be at least 11 months from your next to qualify as "Annual."

It would be best if you planned to bring all the completed questionnaires with you to the appointment, and you may wish to take a copy of the "Documentation of a Wellness Exam" with you as most physicians have not read Medicare's Claims Processing Manual Chapter 18; Section 80 and 140 (Available on the Internet). Keep on task as this appointment is not for prescription refills nor for discussing acute or chronic medical problems unless germane to what Medicare classifies as Preventive topics.

The clinic should not request any Co-Pay when you check-in, nor any payment when you check out as Medicare waives all deductibles, co-insurance, and co-pays for the Preventative Annual Wellness Visit.

Patient Questionnaire

This document records your Medications, Allergies, Personal health Habits, Dates of last Preventative Health exams or tests, Past Medical Illnesses, Immunization history, Past Hospitalizations, and Surgeries, Family Health History and Review of Systems. The results are a summarization of your health risks. Take a completed copy to your Annual Wellness Visit. Keep your text and update that copy annually.

Screening Questionnaires

You should annually open each of the attached questionnaires and complete them, print them, and take a copy to your Wellness Visit. They cover Alcohol, Depression, Dementia, Sleep Apnea, and Quality of Life. These or their equivalent are required information Medicare expects your provider to obtain. By doing this yourself, you will have efficiently provided your PCP with important information leaving time for more face-to-face interaction and counseling.

Advanced Directive

You should have an Advanced Directive. Copy yours and take it with you to your Annual Wellness Visit and discuss any questions or concerns you have with your provider. If you do not have a Directive, print out and complete it to the best of your ability and take it with you to your Annual Wellness Visit. Over the years, you may wish to alter this Directive, so keep your provider and family updated on your end-of-life decisions.

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