Medicare will cover an annual wellness visit, but not an annual physical. "Well," you might ask "what's the difference?" During a Medicare annual wellness visit, the provider will measure height, weight, body mass index (BMI), and blood pressure. The provider will also go over your medical history, family medical history, and any potential risk factors for preventable diseases such as Type II diabetes and depression.
An annual physical is a more extensive exam than a Medicare Annual Wellness Visit. In addition to these services, a typical annual physical might also include services such as a vital signs check, lung exam, head and neck exam, abdominal exam, neurological exam, and a check of your reflexes. Any blood work or lab tests that may be part of a physical exam, are also not included under a Medicare Annual Wellness Visit.
The purpose of the annual wellness visit under Medicare is to paint a picture of your current state of health and to create a baseline for future care. Any additional tests or labs that may be required as a result of the findings of your annual wellness visit would be billed separately by your doctor and would fall under a different benefit than your annual wellness visit. Medicare also covers a number of other preventive services at no cost such as preventive cancer screenings, bone density measurement, and flu shots.
The Medicare Wellness exam includes the assessments, but none of the "physical" tests where the doctor has to physically touch you. Under Medicare, a doctor will only perform these types of services if there is a specific diagnosis or symptom which necessitates that type of examination. Other preventive services will be scheduled, but not performed, during your wellness visit. You can find a complete list of covered preventive services under Medicare here. If you have more questions regarding Medicare coverage and what services are covered, you can contact our Care Coordinator at 518-782-3800.