What’s included in the ‘Welcome to Medicare visit’?
The “Welcome to Medicare visit” was created, so new Medicare beneficiaries can get an up-to-date snapshot on their health, including important screenings and vaccinations and discussing their medical history and how to stay healthy with their doctor.
It is the opportunity for a health care provider to comprehensively review the patient’s health. It enables them to identify possible risk factors that might be associated with various diseases, and to detect diseases at an early state, when the outcome is best. It’s also a chance for the health care provider to educate their patient about the services covered by Medicare that may be needed to prevent, detect, and manage diseases, to consult them on risk factors and suggest lifestyle changes that may have a positive impact on their health, and to issue referrals or schedule follow-up appointments for necessary care.
Beneficiaries enrolled in Medicare Part B have one year from their enrollment date to take advantage of this one-time visit.
The Welcome to Medicare visit is a thorough examination and consists of the following 7 points:
- An individual’s medical and social history with attention to modifiable risk factors
- An individual’s potential risk factors for depression
- The individual’s functional ability and level of safety
- A physical examination to include an individual’s height, weight, blood pressure, visual acuity, and measurement of body mass index
- End-of-life planning
- Education, counseling, and referral based on the results of the review and evaluation services described in the previous five components
- Education, counseling, and referral, including a brief written plan such as a checklist for obtaining the appropriate screening and/or other Medicare Part B preventive services
Note: Reimbursement for clinical laboratory tests is not included; screening and other preventive services that are currently covered and paid for by Medicare Part B, may be billed separately.
Medicare will pay for a one-time ultrasound screening for Abdominal Aortic Aneurysm (AAA) for beneficiaries who are at risk. Eligible beneficiaries must receive a referral for the screening as a result of their Welcome to Medicare physical exam.
Coverage of the visit is provided as a Medicare Part B benefit. The annual Part B deductible is waived if the visit does not include the electrocardiogram, which is no longer a required part of the visit. However, if the EKG is included as part of the visit (performed with or without interpretation and report, or just its interpretation and report), the deductible will apply. The coinsurance or co-payment still applies regardless of the type of Welcome to Medicare visit the beneficiary receives.
