Medicare’s Initial Prevention Visit

Have you recently enrolled in Medicare, or will you in the near future? If so, let me be the first to say, welcome! What should your first step be as a new Medicare beneficiary? I recommend taking advantage of the “Welcome to Medicare” preventive-care benefit.

During the first 12 months that you have Medicare Part B, you can get a “Welcome to Medicare” preventive visit with your doctor. This visit includes a review of your medical and social history related to your health. Your doctor will also offer education and counseling about preventive-care services, including certain disease screenings, shots, and referrals for other care, if needed.

When you make your appointment, let your doctor’s office know that you’d like to schedule your “Welcome to Medicare” visit. You pay nothing for this if your doctor or other qualified health-care provider accepts Medicare payment rates.

If your doctor or other health-care provider performs additional tests or services during the visit that aren’t covered under this preventive benefit, you may have to pay coinsurance, and the Part B deductible may apply.

Here’s what your doctor will do during your “Welcome to Medicare” visit:

Record and evaluate your medical and family history, current health conditions, and prescriptions.

Check your blood pressure, vision, weight, and height to get a baseline for your care.

Make sure you’re up-to-date with preventive services such as cancer screenings and shots.

Order further tests, depending on your general health and medical history.

Following the visit, your doctor will give you a plan or checklist with free screenings and preventive services that you need.

You should do a little preparation before you sit down with your doctor. Pull together your medical records, including immunization records. Even if your current physician does the visit, gather as much medical information as you can to make sure nothing is overlooked.

Try to learn as much as you can about your family’s health history before your appointment. The information will help you and your doctor understand what screenings you should get and what to watch for in the future.

And bring a list of any prescription drugs, over-the-counter drugs, vitamins, and supplements that you currently take, how often you take them, and why.

If you’ve had Medicare Part B for longer than 12 months, you can get a yearly “Wellness” visit to develop or update a personalized plan to prevent disease or disability based on your current health and risk factors.

Medicare covers this visit once every 12 months.

Your doctor or other provider will ask you to fill out a questionnaire, called a “Health Risk Assessment,” as part of this visit. Answering these questions can help you and your provider develop a personalized prevention plan to help you stay healthy and get the most out of your visit. The questions are based on years of medical research and advice from the U.S. Centers for Disease Control and Prevention.

When you make your appointment, let your doctor’s office know that you’d like to schedule your yearly “Wellness” visit.

Note: Your first “Wellness” visit can’t take place within 12 months of your enrollment in Part B or your “Welcome to Medicare” preventive visit. However, you don’t need to have had a “Welcome to Medicare” preventive visit to qualify for a “Wellness” visit.

As with the “Welcome” visit, you pay nothing for the yearly “Wellness” visit if your doctor or other qualified health-care provider accepts Medicare payment rates.

If your doctor or other health-care provider performs additional tests or services during the same visit that aren’t covered under this preventive benefit, you may have to pay coinsurance, and the Part B deductible may apply.

Cate Kortzeborn is Medicare’s acting regional administrator for Arizona, California, Hawaii, Nevada, and the Pacific Territories. You can always get answers to your Medicare questions by calling 1-800-MEDICARE (1-800-633-4227).