Welcome to age 65, and the Medicare system! Now you can sit back, relax, and know that you’ll be taken care of no matter what happens.

You can dream, but if you’ve already crossed this important threshold, you know that’s not the reality. When you’re tapping into government benefits, it pays to know the terms. Before you schedule your first visit, know the difference between the Welcome to Medicare visit, the Annual Wellness Visit and a physical exam.

            

Welcome to Medicare visit

Under original Medicare, the Welcome to Medicare visit is a one-time visit covered by Medicare Part B with the goal to promote general health and help prevent diseases. It is not necessarily a physical examination at all but instead focuses on creating a baseline health assessment by checking vital stats and health history.

Medicare does not pay for the type of comprehensive exam that most people think of as a physical. But it does cover a one-time Welcome to Medicare checkup during your first year after enrolling in Part B and, later on, the Annual Wellness visit intended to keep track of your health.

Here’s what to expect from the Welcome to Medicare visit:

• Intake: height, weight, body mass index (BMI), blood pressure, vision.

• Review: health history including medical, social and emotional.

• Education: discuss navigating safely as you age, counseling and referrals as necessary.

• Plan: goals and plans for the future, including info on other preventive services.

The visit has no copay or deductible as long as you see a participating provider who will charge no more than the Medicare-approved amount. That means you should verify with your doctor’s office at the time you make the appointment to be sure she or he is a participating provider. If not, you will have to decide whether to change doctors or pay out of pocket.

To make sure you are not charged for the appointment, request the Welcome to Medicare visit or the Annual Wellness Visit—not a physical. Conversely, if you want a full physical examination, request that and be ready to pay for it.

 

Annual Wellness visit

After Welcome to Medicare is your Annual Wellness visit. If you have no intervening issues, you would schedule this appointment for a year after your welcome visit, and each year following.

The content is similar, where intake stats are measured and compared to the values at your Welcome to Medicare visit. They’ll review your health history, looking especially for changes in health or cognitive impairment. Some screenings may be ordered periodically, such as lipid blood panel for cholesterol (5 years), colorectal cancer screenings (12-120 months) and mammogram (annual). The visit may also include a discussion of advanced care planning, encouraging you to prepare for the possibility of not being able to care for yourself.

The Annual Wellness visit is covered under Medicare Part B with no deductible unless your Medicare-approved provider orders a test or screening that is not part of the annual benefit. In that case, you may be subject to whatever copays and deductibles come with the plan you purchased.

If in the course of your exam an issue arises that needs diagnosis or treatment, these may involve extra charges. Just as before your Medicare days, these are subject to various deductibles and copays.

If you have a Medigap (supplemental Medicare) or Medicare Advantage plan, some or all of these costs may be covered. It is generally a good idea to buy the best Medicare supplemental plan that you can afford from the beginning. If your health fails later, you may not be able to qualify for the plans with the best coverage.

It’s important to be informed and discerning about your own health. While medical professionals help monitor our state of health and nip big problems in the bud, remember that self-care is the most important factor in health and longevity. Daily exercise is a great way to practice self-care. If scheduling exercise is difficult for you, at least make a practice of taking the farthest space in the parking lot for your doctor’s office!