Are you aware that under Medicare you are entitled to an annual wellness visit to your primary care physician once every 12 months? Even though Medicare does not cover a routine physical exam, it does pay for the annual wellness visit, which comes under the Patient Protection and Affordable Care Act of 2010 (health care reform law).
This new benefit, which began Jan. 1, 2011, has elements that are similar to a check-up or physical. It also includes the creation of a personalized prevention plan and detection of possible cognitive impairment, both are steps toward better healthcare management, reduction in missed or delayed dementia diagnosis and more favorable outcomes for patients.
Any Medicare beneficiary who has been receiving Medicare Part B benefits for at least 12 months' and has not had an initial preventive physical examination, a "Welcome to Medicare" exam within the past 12 months, is eligible for the wellness visit. Medicare Part B deductible and coinsurance payments do not apply to this annual wellness visit.
What does "detection of possible cognitive impairment" during the wellness visit mean? The doctor or health professional will assess the patient's cognitive function by direct observation, information obtained from the patient and concerns by family members, friends and caretakers. The doctor may ask question about changes in your memory, language and your ability to complete routine tasks.
Prior to or during your appointment, the doctor or health professional will ask questions about your health, through an instrument called the Health Risk Assessment. This tool is basically a health questionnaire. The doctor uses it to provide the patient with their health risks and quality of life issues. The Centers for Disease Control and Prevention define an HRA as "a systematic approach to collecting information from individuals that identifies risk factors, provides individualized feedback, and links the person with at least one intervention to promote health, sustain function and/or prevent disease."
HRAs may vary but most capture information related to demographic characteristics, lifestyle, personal and family medical history, physiological data and attitudes and willingness to change behavior to improve health.
In other words, the doctor usually checks the heart, lungs and other body systems to make sure they are working properly. The doctor will ask questions about your daily routine, medical history and memory, and take routine measurements like height, weight and blood pressure.
It doesn't have to be a doctor who provides your wellness check. For this visit, Medicare recognizes other practitioners, such as nurse practitioners, physician assistants, clinical nurse specialists, health professionals including health educators, registered dieticians or nutrition professionals, or a team of medical professionals under the direct supervision of a physician.
When you go for your annual wellness visit, make sure you take your completed Health Risk Assessment, if you were provided one ahead of your appointment. Also take your list of medications as well as vitamins and over-the-counter drugs. If you don't have a list or don't have time to make a list, take your medication bottles with you for the doctor to review. Before your appointment, think about two or three of your health care concerns or questions to ask the doctor. Bring a family member or friend with you to your appointment, if you are concerned about your memory or a chronic health condition you have, such as depression, diabetes or heart disease.
If your doctor or health professional has not talked to you about having a Medicare annual wellness visit, ask him or her about it and schedule the visit. You are entitled to it.
Many thanks to Ilene Rosenthal, Program Director for the Alzheimer's Association Greater Maryland Chapter, for providing this key information on the Medicare annual wellness visit.