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FAQ: Medicare Annual Wellness Visits

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An agent from Newark, New Jersey asks…

Q: Can you explain the new “annual wellness visits” that are coming to Medicare in 2011? What do they cover? How do they compare to the “Welcome to Medicare” exam which is currently available?

A: Starting next year, Medicare will cover an annual wellness visit, which will be similar to an annual physical, except with a higher emphasis on preventive care. The exam is similar to the Welcome to Medicare exam, except beneficiaries are able to have a free visit every year, rather than just once within the first year of enrolling.

During the visits, doctors will work with beneficiaries to create a personalized prevention plan, and the following services will be covered in exam:

  • Routine measurements such as height, weight, blood pressure, and body-mass index (or waist circumference, if appropriate)
  • Review of medical and family history, including medications and current care by other healthcare providers
  • A personal risk assessment (including any mental health conditions)
  • A review of the beneficiaries functional ability and level of safety, including an assessment of any cognitive impairment and screening for depression
  • Set up a schedule for Medicare’s screening and preventive services for the next 5 to 10 years
  • Any other advice or referral services that may help intervene and treat potential health risks.

In addition, the following preventive services that Medicare currently covers will be provided free of charge to the patient, including:

  • Mammograms every 12 months for eligible beneficiaries age 40 and older
  • Colorectal cancer screening, including flexible sigmoidoscopy or colonoscopy
  • Cervical cancer screening, including a Pap smear test and pelvic exam
  • Cholesterol and other cardiovascular screening.
  • Diabetes screening
  • Medical nutrition therapy to help people manage diabetes or kidney disease
  • Prostate cancer screening
  • An annual flu shot, a vaccination against pneumococcal infection (that may cause pneumonia), and the hepatitis B vaccine
  • Bone mass measurement
  • Abdominal aortic aneurysm screening to check for a bulging blood vessel
  • HIV screening tests for people of who are at increased risk or who ask for the test

If you would like to be considered for our Medicare FAQ expert panel to answer frequently asked questions, email associate editor Heather Trese.

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