Do Medicare Supplement Plans Cover Annual Physicals?
Medicare Supplement Plans cover annual wellness exams and a “welcome to Medicare” visit, however, they do not cover annual physical exams.
Their purpose is to fill gaps in Original Medicare coverage, such as deductibles, copayments, and coinsurance. They do not provide coverage for services that Original Medicare doesn’t cover.
If you’re finding this answer confusing, you’re not alone. It can be helpful to better understand the differences between these types of exams and how they relate to your health needs.
Medicare’s Welcome To Medicare Visit
The one-time Welcome to Medicare checkup is a comprehensive preventive examination covered within the first 12 months after enrolling in Medicare Part B.
This checkup is designed to assess your overall health and identify potential health risks or conditions, allowing for early detection and timely intervention.
It Includes:
- A review of your medical and social history
- Measurement of height, weight, and blood pressure
- Exploring your potential risk factors for depression and the dangers of falling
- Screening for cognitive impairment (if necessary)
- If required, provide education and counseling on preventive services, including screenings, vaccinations, and necessary referrals for additional care.
Medicare’s Annual Wellness Visit
Medicare offers coverage for an annual wellness visit once every 12 months, starting from your second year with Medicare Part B. These visits are similar to the “Welcome to Medicare” preventive visit but include additional benefits such as updating your prescription list and receiving personalized health advice based on your current health status.
What Are The Differences Between Annual Wellness Visits And Physicals?
It’s important to understand that an annual wellness visit and a physical exam are not the same thing, even though they offer similar services. The primary difference between the two is that an annual wellness visit is focused on preventive care, whereas a physical exam is designed to diagnose and treat existing illnesses.
The Annual Wellness Visit has no copay or deductible under Original Medicare Part B, while an annual physical could require you to pay the entire cost of the service.
How Can I Get These Services?
If you want to take advantage of any preventive services mentioned above, the first step is to reach out to your primary care provider. They can help you schedule an appointment and determine whether or not Medicare covers it.
It is important to note that depending on your policy, you may have to pay some of the costs associated with these preventive services. Check with your provider or insurance company before receiving any care.
What About Medicare Advantage?
Medicare Advantage plans must cover the same preventive services that Original Medicare covers, including annual wellness visits and one-time welcome to Medicare Visits.
However, remember that some plans may cover additional preventive care such as flu shots, cervical cancer screenings, and other health screenings.
Bottom Line:
While Medicare Supplement Plans or Medigap do not typically cover routine annual physicals, it’s important to remember that there are other viable options.
Beneficiaries still have access to other forms of preventative care, including the Welcome to Medicare Visit and the Annual Wellness Visit, both of which are covered under Medicare Part B.
These visits focus on maintaining wellness, detecting potential health risks early, and providing personalized advice to optimize health. Additionally, those enrolled in Medicare Advantage plans can benefit from a broader range of preventive services, depending on their specific plan.
Sources: AARP – Medicare.gov – HealthLine
FAQs
Does Medicare cover routine annual physicals?
No, Medicare does not typically cover routine annual physicals. However, it does cover the costs of annual wellness visits and a “Welcome to Medicare” visit.
How often will Medicare pay for routine blood work?
Medicare Part B covers diagnostic non-laboratory tests like X-rays, MRIs, CT scans, and some blood tests deemed necessary by your provider.
