Checkups and the Medicare Wellness visit

Posted by sandyjr @sandyjr, Aug 13, 2023

As a 2 time cancer survivor who is 5+ years out from the second cancer, how do I get a “yearly physical”? The Medicare wellness exam is not an exam. Basically it’s just a bunch of questions and it is nothing like your yearly physical when you were younger. So what does a person do to get a yearly physical when Medicare will not pay for it? I will no longer be seeing my oncologist who can order tests for me and keeps an eye on different things that might indicate cancer again but apparently the wellness exam is not a place to discuss these issues. I would like to get the same bloodwork and physical that I got before I became “old”. Unfortunately, it seems that nobody really cares about senior citizens. I would like some pointers on how to keep up with keeping yourself healthy in old age.

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How it appears to me and I am new to Medicare, I have Parts A &B with a "G" supplement which covers everything but the small Part B deductible.
How you Dr's office bills it out will be how Medicare pays for it or not. If your Dr's office is billing your visits as "well" you're being taken advantage of. Face it at our age, when do we go to a Dr. and walk out 100% well, oh yeah never! So never let them bill it that way. Some Drs want to bill it out so it doesn't get paid so you are on the hook for the whole bill usually at a far more price than would they have been paid by Medicare.
I always ask before I go is this covered? If not then I simply don't go.
Hope that helps!!!

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The annual wellness is a required annual visit with medicare. My husband is seen in primary care twice annually by the doctor and has a brief physical and any issues addressed. This is in addition to a wellness visit by a nurse who checks in with vitals, and making sure you are getting what you need from your doctors and you are in safe living environment. This visit is a good time to ask for a visit with your primary to address any issues you might be having.
You can ask for an appointment for a physical, but physicals (to my eyes) do not look like they did in the past. It is questions and answers, vitals and maybe blood work.
@sandyjr would this work for you, asking for an appointment for a physical work up appointment?

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Your post caught my eye. I am not on Medicare yet, but have insurance through my employer(pretty good too). My last physical was a list of questions the Dr. read off her computer, she checked vitals, and then did blood work at my request as she said not it is not necessary every year. I just got a form letter from the medical practice I use( it is a big one and the main one in the area) stating if during a physical exam ( and they are nothing like they used to be)if any other issues are brought up then you and and your insurance will be billed for a physical and an office visit. Healthcare is a mess and it is at the expense of the patient.

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I am not yet on Medicare (I pay $1,000 a month for a lousy policy via the Health Connector in MA) but I do handle my father's Medicare as well as his supplemental insurance. I'm wondering if perhaps you don't have a supplemental plan for doctor visits etc. I pay $400 a month for his supplemental BXBS Illinois plan and another $100 for drug coverage (he pays a late entry fee as was a pharmacist and didn't sign up for drug coverage when he should of to avoid late entry fee). He has dementia now in a assisted living and will run out of money soon - I think I could find a less expensive Medicare Adv plan but he's had this Cadillac supplemental plan forever and without it, he would have paid so much more out of pocket especially for my mom's cancer treatments at Mayo Clinic before she passed. This wellness exam is such a racket - and I hope you can talk to your PCP to help with proper billing codes. Keep us posted. xo

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I pay $49 a month for UnitedHealthcare Medicare Advantage Plan and $58 for dental rider. I started Medicare in my mid-50s since I was on SSDI. UnitedHealthcare is an excellent insurance company. They even paid two hospital bills at 100 percent! Keep the faith. It will get better for you.

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@maggie1955

I pay $49 a month for UnitedHealthcare Medicare Advantage Plan and $58 for dental rider. I started Medicare in my mid-50s since I was on SSDI. UnitedHealthcare is an excellent insurance company. They even paid two hospital bills at 100 percent! Keep the faith. It will get better for you.

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maggie1955, agree I also have United Healthcare Part G and I've had -0- issues with them paying. I pay $114.00 a month, its through AARP. And bonus it's called Active Renew or Renew Active and I get a free gym membership which has been the best ever RX for me! I was up to 2.5 miles a day walking on the track and at home when I broke my foot! Uggg now I'm at the outdoor gym pool doing running/walking in water.

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Glad to hear you're happy about your insurance! Pools are special to me. I swam 40 laps every day for a year 5 years ago. You're doing great. Hope your foot heals soon.

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@maggie1955

Glad to hear you're happy about your insurance! Pools are special to me. I swam 40 laps every day for a year 5 years ago. You're doing great. Hope your foot heals soon.

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Thank you! I'm in awe of your swimming, I really do enjoy being in water 🙂 but I can't swim very well, running/walking in water with a water belt is more my speed.
Foot feels a little better every day 🙂

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