Medicare Wellness Exam

2014 Medicare and Medigap Updates

Medicare Wellness Exam

A welcome development that began in early 2012 is the inclusion of the Medicare wellness exam to the annual Medicare coverage package for members. Before, Medicare simply offered the “Welcome to Medicare” examination as a way to gauge the health status of members who were admitted to their first Medicare coverage soon after they turned 65. Today, new provisions in the Medicare Reform Bill have ushered the extra benefit of wellness exams that are aimed at making sure the health condition of members are tracked and monitored on a regular basis.

The Medicare Wellness Exam is built into Medicare Part B coverage. This means that anyone with Part B policies is eligible for the exam. Medicare pays for the medical bills once per year. This is done at no extra cost to the member. However, patients must take notice of the procedures that were done during the exam in order to determine if extra procedures might require extra expenses that will not be shouldered by Medicare.

The importance of a Medicare wellness exam can never be understated. It is designed to spot potentially serious illnesses while they are still in the beginning stages and easily treatable. More importantly, these exams should enable the patient and doctor to come up with prevention plans that are continually reinforced with each subsequent examination.

A typical Medicare wellness exam includes the following procedures: a physical which includes height, weight, blood pressure and Body Mass Index. Medical histories will also need to be updated to reflect the changes in the previous year. If a close blood relative, for example, has developed serious conditions like diabetes or heart ailments, these should be included in the family history as a reference for creating prevention plans that mitigate the risk factors for the patient.

Of course, one shouldn’t expect a standard Medicare wellness exam to ferret out all the health issues that the patient is suffering from. In many cases, this only serves as an introductory phase towards what might become a more comprehensive medical exam depending on the patient’s exact condition. Therefore, it is extremely important to draw the line between routine and extra so the patient knows the added potential bills and payments necessary to get on with the procedure.

Because this provision has only recently been added to Medicare, it is still in its infancy. As such, many members have yet to take advantage of the Medicare wellness exam. In the coming years, the hope is that more and more Medicare members open themselves up to a regular procedure that helps them keep track of their health condition and meet their health goals.

It should be stressed to all that there is tremendous value in the Medicare wellness exam. It is undoubtedly a significant improvement versus the old system where co-payments were required for the patient to be properly examined on a regular basis. In the future, the Medicare wellness exam should promote a better understanding of the importance of preventing illnesses before they become serious rather than using Medicare as a vehicle purely for the treatment of illnesses. As the saying goes, an ounce of prevention is better than a pound of cure.