Preventive care is important for helping to detect and prevent various diseases or conditions throughout your lifetime. These services can become especially vital as you get older.
When you start Medicare, you’re eligible to have a “Welcome to Medicare” preventive visit. During this visit, your doctor will review your medical history and provide you with information about various preventive services.
The Welcome to Medicare visit was used by
But what specifically is and isn’t included in this visit? This article explores the Welcome to Medicare visit in greater detail.
Medicare Part B covers a one-time Welcome to Medicare visit. You can complete this visit within 12 months of starting Medicare.
You won’t pay anything for your Welcome to Medicare visit unless you’re provided with services that aren’t included, such as laboratory tests and health screenings.
Here’s what the Welcome to Medicare visit includes.
Medical and social history
Your doctor will review yourmedical and social history. This can include things like:
- previous illnesses, medical conditions, or surgeries you’ve experienced
- any diseases or conditions that run in your family
- medications and dietary supplements you’re currently taking
- lifestyle factors, such as your diet, level of physical activity, and history of tobacco or alcohol use
An exam
This basic exam includes:
- recording your height and weight
- calculating your body mass index (BMI)
- taking your blood pressure
- performing a simple vision test
Safety and risk factor review
Your doctor may usequestionnaires or screening tools to help determine things like:
- any signs of hearing loss
- your risk for falls
- the safety of your home
- your risk for developing depression
Education
Based off the information they collect, your doctor will work to advise and inform you on a variety of topics, including:
- any recommended health screenings
- vaccinations, such as a flu shot and pneumococcal vaccine
- referrals for specialist care
- advance directives, such as if you want to be resuscitated if your heart or breathing stops
It’s important to note that the Welcome to Medicare visit isn’t an annual physical. Original Medicare (parts A and B) doesn’t cover annual physicals.
An annual physical is much more detailed than a Welcome to Medicare visit. In addition to taking vital signs, it can include other things, such as laboratory tests or respiratory, neurological, and abdominal exams.
Some Medicare Part C (Advantage) plans may cover annual physicals. However, this may vary by specific plan. If you have a Part C plan, be sure to check on what’s covered before scheduling an appointment for a physical.
Yearly wellness visits
Once you’ve been using Medicare Part B for more than 12 months, it will cover a yearly wellness visit. A yearly wellness visit can be scheduled once every 12 months.
This type of visit includes most of the components of the Welcome to Medicare visit. It can be very useful for updating your medical history and care recommendations.
Additionally, a cognitive assessment is performed as part of a yearly wellness visit. This can be used to help detect conditions like dementia or Alzheimer’s disease early.
Like the Welcome to Medicare visit, you’ll need to pay for some or all of any additional screenings or tests that aren’t covered in the wellness visit.
Your doctor can perform your Welcome to Medicare visit if they accept assignment. This means they agree to accept a payment directly from Medicare at a Medicare-approved amount for the services provided in the visit.
Your doctor should let you know before they perform any services that aren’t included in the Welcome to Medicare visit. That way, you can choose if you want to receive those services at that time.
Preventive care can help detect serious conditions early. According to the Centers for Disease Control and Prevention (CDC), the three
- heart disease
- cancer
- chronic lower respiratory disease
Preventive care can help detect these conditions and others, ensuring early treatment.
Screening tests Medicare covers
| Condition | Screening test | Frequency |
|---|---|---|
| abdominal aortic aneurysm | abdominal ultrasound | once |
| alcohol misuse | screening interview | once a year |
| breast cancer | mammogram | once a year (over 40 years old) |
| cardiovascular disease | blood test | once a year |
| cervical cancer | Pap smear | once every 24 months (unless at higher risk) |
| colorectal cancer | colonoscopy | once every 24–120 months, depending on risk |
| colorectal cancer | flexible sigmoidoscopy | once every 48 months (over 50) |
| colorectal cancer | multi-target stool DNA test | once every 48 months |
| colorectal cancer | fecal occult blood test | once a year (over 50) |
| colorectal cancer | barium enema | once every 48 months (in place of colonoscopy or flexible sigmoidoscopy over 50) |
| depression | screening interview | once a year |
| diabetes | blood test | once a year (or twice for higher risk or prediabetes) |
| glaucoma | eye test | once a year |
| hepatitis B | blood test | once a year |
| hepatitis C | blood test | once a year |
| HIV | blood test | once a year |
| lung cancer | low dose computed tomography (LDCT) | once a year |
| osteoporosis | bone density measurement | once every 24 months |
| prostate cancer | prostate specific antigen (PSA) test and digital rectal exam | once a year |
| sexually transmitted infections (STIs) | blood test for for gonorrhea, chlamydia, syphilis, and hepatitis B | once a year |
| vaginal cancer | pelvic exam | once every 24 months (unless at higher risk) |
Vaccinations
Some vaccinations are also covered, such as those for:
- Hepatitis B. It’s applicable for individuals who have a medium or high risk for contracting hepatitis B.
- Influenza. You can get a flu shot once per flu season.
- Pneumococcal disease. Two pneumococcal vaccines are covered: the 23-valent pneumococcal polysaccharide vaccine (PPSV23) and 13-valent pneumococcal conjugate vaccine (PCV13).
Other preventive services
Additionally, Medicare covers further annual preventive services, including:
- Alcohol misuse counseling. Receive up to four face-to-face counseling sessions if you misuse alcohol.
- Behavioral therapy for cardiovascular disease. Meet once a year with your doctor to discuss strategies to help lower your risk for cardiovascular disease.
- Diabetes management training. Get tips for monitoring blood sugar, eating a healthy diet, and exercising.
- Nutrition therapy. Work with a nutrition professional if you have diabetes, kidney disease, or have received a kidney transplant in the past 36 months.
- Obesity counseling. Face-to-face counseling sessions can help you lose weight if you have a BMI of 30 or more.
- STI counseling. Two face-to-face counseling sessions are available for sexually active adults who have an increased risk for STIs.
- Tobacco use counseling. Get eight face-to-face sessions over a 12-month period if you use tobacco and need help quitting.
tips for effective preventive care
- Use it! Less than
50 percent of adults over age 65 are up to date with core preventive care, such as screenings and vaccinations.- Regularly check in with your doctor. It’s a good rule of thumb to visit your doctor for a checkup at least once per year, according to the Mayo Clinic.
- Maintain a healthy lifestyle. Making healthy choices about exercise, diet, and tobacco use can all help improve your overall health and reduce the risk of conditions like cardiovascular disease and cancer.
- Communicate openly with your doctor. Talking to your doctor about your health can help them make decisions about tests and screenings. Let them know if you have a family history of a specific illness or condition, new or worrisome symptoms, or other health concerns.
The health screenings you need may depend on several factors, such as your age, overall health, risks, and current Medicare guidelines.
Preventive care is important for the prevention and detection of various conditions or illnesses. The Welcome to Medicare visit can aid your doctor in assessing your health and making care recommendations.
You can schedule your Welcome to Medicare visit within 12 months of starting Medicare. It includes taking your medical history, a basic exam, assessing risk and safety, and making healthcare recommendations.
The Welcome to Medicare visit isn’t an annual physical. Things like laboratory tests and screening exams aren’t included.
However, Medicare may cover some of these services as preventive care at specific intervals.