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Getting the Most from Your Medicare Wellness Exam

Author: Beth Perry    Posted: April 14, 2015

The Affordable care Act has changed the “Annual Exam” for all insurance plans including Medicare Supplements and Medicare Advantage plans. The ACA mandates that these exams be offered for seniors on an annual basis at no cost. Certain labs and other services may be included.

How do you get the most from your short time with the doctor?

  • When you set the appointment, state you want a Medicare Annual Wellness Exam. This includes a specific list of services that may be different from an annual visit or exam.
  • Be prepared: Have a list of your current medications with you or bring in your pill bottles. A check of medications is one of the most important things that is done in this visit. Your PCP will be on the look-out for negative drug interactions, overdosing and ongoing effectiveness.
  • Be open with your doctor about changes in your life. Have you moved, are you now living alone, are you eating well or sleeping poorly, feeling anxious or depressed? These may be clues that a closer look or referral may be needed. The doctor cannot help if you tell them you are fine when you are not.
  • Ask for a renewal of any referrals to specialists if your Medicare Advantage plan requires this. Arrive with a list of specialists you see. Referrals must be renewed annually.
  • Ask for a renewal of any pre-authorization of other special exceptions that may be required for medications. These too are required each year.
  • Get a flu shot if you and your doctor deem that to be part of your care.

Keep in mind the Annual Wellness Exam is not the time to tell the doctor about significant new problems or expect a diagnosis of current symptoms. If you are having a problem, call and change the appointment to a diagnostic session or make a second appointment. Lab work, aside from the specific items covered as part of a wellness visit may not be covered.

For women: be sure to get your mammogram and other women’s health screening done as prescribed by your doctor. This type of lab can be either preventive or diagnostic, depending on you, what is done and the codes used. If you are not sure, ask.

Keep your ongoing relationship with your PCP current and vital. This is the person who will oversee everything that happens in your life. Your PCP is your coach and coordinator. As we all age becomes an more important part of a healthy and happy life.

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