Welcome to Medicare Visitby Denise Early on May. 06, 2013, under Health
When people first begin their Medicare coverage, they get a free “Welcome to Medicare” visit with a primary care doctor. This preventive screening visit might not be important to someone who has had health insurance and has seen their primary care physician every year or two. But I meet quite a few people who have not had health insurance and have not been to a doctor in many years.
This is from Medicare.gov:
“Welcome to Medicare” preventive visit: You can get this introductory visit only within the first 12 months you have Part B. This visit includes a review of your medical and social history related to your health and education and counseling about preventive services, including certain screenings, shots, and referrals for other care, if needed. It also includes:
- Height, weight, and blood pressure measurements
- A calculation of your body mass index
- A simple vision test
- A review of your potential risk for depression and your level of safety
- An offer to talk with you about creating advance directives
- A written plan letting you know which screenings, shots, and other preventive services you need
When will you pay?
While the Welcome to Medicare visit is free, with no co-pay, no co-insurance, or deductible, if the conversation goes beyond the services listed above, there will be a bill.
An example: Mary has not been to a doctor in years. She has just gotten her Medicare and she visits her doctor for her “Welcome to Medicare” screening. The doctor goes through his list of questions for Mary and then asks her if there is anything else she’d like to discuss.
Mary says she is concerned about her sore shoulder which she can hardly move without lots of pain. When the doctor checks out the shoulder and moves her arm up and down to see what causes her pain….that has gone beyond the wellness visit. Now Mary will be getting a bill.
A doctor office visit comes under Medicare Part B, and Part B has an annual deductible of $147 (in 2013). If Mary has only Medicare (and no supplement), she will get a bill, probably for $147. It all depends on the billing code the doctor uses and what the charge for that code is. It also depends on what else the doctor might address beyond the “Welcome to Medicare” list above. If the total bill is more than $147, the patient will be responsible for 20% of the rest of the bill. That shouldn’t be to much.
If Mary has a Medicare supplement Plan N, she will have to pay the Part B deductible ($147). If Mary has a Medicare supplement Plan F, she will owe nothing on the bill because her Plan F will pay the $147 deductible and any co-insurance.
If Mary is enrolled in a Medicare Advantage plan, she will be charged the doctor visit co-pay because the doctor went beyond the “Welcome to Medicare” list of services. Advantage plan co-pays for Primary Care visits range from $0 to $25, depending on the plan.
For a quick overview of your Medicare choices, see this video: Intro to your Medicare Choices