Medicare assessment/wellness exam

[johngross]

I enrolled in Medicare Part B in March, and yesterday my Primary Care Doctor's office called to schedule my "Assessment." I told them I already had a physical at their office about six months ago and things looked peachy keen, so there's nothing to assess at this time. The girl said no, this is different. Long story short I told the girl I'll think about it.

I checked it out online and it looks like it's covered "free" (HAHA) by Medicare, but also looks like providers can sneak in some costs not covered and you wind up paying for those.

Here's an example from the web about extra costs (full article linked below).

"Another potential problem with the annual wellness visits, Dr. Ganguili notes, is that many patients end up with unexpected medical bills from what they thought was a free checkup. While the basic wellness exam is free, if a provider discovers an issue during the visit, like knee pain or a cough, they are allowed to bill for the evaluation of that issue."

Is the Medicare Wellness Exam Mandatory? - Continuum

Any of you guys/gals get this done each year, or do you just skip it? (It doesn't appear to be mandatory).

Thanks.

 

[TJm15.38]

I get the Medicare Wellness Exam done every year by choice. For me it is a good thing, because I deal with a couple of health issues that require close monitoring. I don't think it is mandatory, however, if you do chose to do it, the exam must be at least 365 days since the previous Wellness Exam or Medicare will not pay for it.

 

[GaryS]

If you don't trust your doctor to be honest, find another doctor.

Ignore all advice you get from websites.

 

[H Richard]

It's basically a annual exam with a set of specific questions for the Dr (usually the Dr's assistant), to ask to determine if further evaluation is needed. Supposedly Medicare will pay YOU a $25 fee for having this exam. I haven't seen that except for the original one many years ago.

 

[HOUSTON RICK]

The medical profession run by doctors has unfortunately become the medical industry run by corporate executives. When we were young, 90% of doctors ran their own practices, now it is less than 30%. There are no healthy patients, every procedure and contact has the purpose of generating a diagnosis or ruse for scaping more money out of you without regard to your benefit or needs.

 

[Rustyt1953]

I have it done annually.

After a $35 co-pay I get a receipt, a lollipop and an obligatory warning about my weight.

Afterwards Ruthie and I use it as a pub date day.

 

[lkabug]

Today's Primary Care physicians very often are employees of a major care facility.
The Primary Care provider's job, while taking care of their patients, is also to feed the mother ship. Sure, they provide care for the minor things, but they refer major items to the mother ship. And they are rewarded for doing so and chastised otherwise.
Thus is corporate medical care in America. For me this system has generally worked well.

 

[ladder13]

Other than the name change from annual physical to wellness exam, I see no change, except the questions about falling and paying bills.

Get labs done a week before, see doctor, who does everything as before. Skin check, rectal exam, ears, eyes, throat, etc etc. reviews my specialist docs treatment, reviews bloodwork, gives me a poop test to send in.
There is nothing we don't discuss. Tells me to call whenever needed.

The Feds and my Bugatti municipal insurance pay everything.

 

[SMSgt]

I've had the Medicare annual for several years with no problems moneywise. I have a secondary insurance that covers almost anything. Be prepared to answer the proverbial mental condition questions--Do you ever feel depressed, have you lost interest in hobbies, etc. After a bout with the VA over these questions, I refuse to answer anything not physically related. My doc said he has to put down something, so I tell him to put down, "Patient refuses to answer."

 

[Bugkiller99]

AWV. Annual Wellness Visit.
It is free. But as others have noted, maybe not. For it to remain free, you can't discuss other problems.
High blood pressure? Nope, don't mention it. Cholesterol high? Talk about it another day. Labs? X rays? Zip it.
Anything related to another problem, chronic condition, etc. and Free is not free.

 

[two-bit cowboy]

For some reason I slipped through the cracks till this year. My nurse told me to show up 15 minutes early for the appointment to take care of the "annual wellness exam." Okay.

Sierra told me she was going to tell me five words and later in the exam she'd ask me what they were. I warned her I couldn't even remember what I'd had for breakfast.

Later in the questioning Sierra asked me what the five words were.

Typical of me, I asked, "What five words"?

Sierra got this devastated look on her face.

Before she could say anything after a few second pause I laughed and told her three of the words. Best I could do.

After my usual round with the doc I left the cubical and sauntered by the nurse's station. The other nurse laughed and said, "I hear you really 'got' Sierra." Sierra joined us in a good laugh and said, "Not often one of you 'gets' me. I'll be on my toes next time."

I didn't get my $25 from Medicare. I'll remember that next year!

 

[LVSteve]

I've had eye issues 90% of my life. When asked about my vision, the reply, "Who said that?" still gets a laugh from most eye care professionals.

 

[fiasconva]

I get those annual tests too. Several of them are designed to check for signs of dementia, like the 5 words and drawing a certain time on a clock face. They seem to be a little silly but when my stepdad started showing signs of his dementia he couldn't do either of the tests.

 

[Skeet 028]

I got a thing from my medical ins carrier to do a virtual Drs visit...and they would give us a 100dollar gift card...one for wife too. We declined to answer after the fourth question. Most none of their business. I had to go get my throat scoped Had an appointment scheduled with the doc 2 weeks prior. Got to meet a NP no doc. Treated me like a 10 year old. Had numerous scopes 3 ablations for esophageal cancer. They had my records. After about 5 mins wife walked out 3 mins later so did I.. Told her I'd see the doc the day of the procedure. Young guy knew his stuff. Asked me why I left the first contact. Told him the truth..They had my records..knew my concerns and they scheduled a doctor visit... Saw a NP and got charged for the doctor. He does work for a large medical services company. Told him I was happy with him but not the company policy. He said OK...see you in a year. I also saw a cardiologist with the same corporation. Atrial Fib...after 2nd visit when he said we should do an ablation on my heart... I said...how about let's do something a bit less invasive...next 4 visits I got to seen A cPA and 3 NPs. I found an independent cardiologist and have been pretty much AF free just with medication. Ablations are a BIG money maker and 80% of the time have to be done 2 to 4 times

 

[GypsmJim]

I have a Medicare Advantage Plan. My plan is free and I get a give-back to Social Security that reduces my Medicare by $30 a month. In return, I pay a couplabucks extra for "routine" Dr. visits and my tier 1 prescriptions are $3 a month, where they used to be free.

My Annual Wellness visit is encouraged, but not mandated. It is completely free with no copay.

Next time Joe Namath or the Dynomite guy advertises, maybe you should look at other options. Paying for a wellness visit is wrong. Surely the Doctor charges for it, but the Insurance company should pay for it with no copay.

 

[Rustyt1953]

I am not about to grouse over $35.

 

[MDF4]

Today's Primary Care physicians very often are employees of a major care facility.
The Primary Care provider's job, while taking care of their patients, is also to feed the mother ship. Sure, they provide care for the minor things, but they refer major items to the mother ship. And they are rewarded for doing so and chastised otherwise.
Thus is corporate medical care in America. For me this system has generally worked well.

My brother is a Doc' and has his own private practice. He has been approached many times by these conglomerate medical service companies but has chosen to keep it a private practice.
I have, however, noticed over the years a slight change in his demeanor with reference to patients. It boils down to this; the cost of a private practice is way up there and the return on investment is nil' when taking medicare patients. Some time back he told me that a standard medicare visit returns about $ 30.00. If you take everything in account eg; physical location, employees, equipment, insurance, tax etc and a host of other things that bite into the profit he said that at a minimum he would have to see 35 patients in a nine hour work day and just maybe break even. Or, he has patients that are on the wait list for surgery that give a far better return. So what does he do? He gives his staff a schedule and the Medicare patients just have to wait or go to another doctor. As he explained; it's not just about the money, it's a matter of survival.

 

[GaryS]

Medicaid pays even less, no matter what it is called in various states. Ask your brother about dealing with CMS.

Doctors come out of school with huge debt. Then comes internship and residency, where they make next to no money.

One thing I've observed over the years is that doctors tend not to be very good at running the business side of things. The smart ones hire a really good business manager.

My brother is a Doc' and has his own private practice. He has been approached many times by these conglomerate medical service companies but has chosen to keep it a private practice.
I have, however, noticed over the years a slight change in his demeanor with reference to patients. It boils down to this; the cost of a private practice is way up there and the return on investment is nil' when taking medicare patients. Some time back he told me that a standard medicare visit returns about $ 30.00. If you take everything in account eg; physical location, employees, equipment, insurance, tax etc and a host of other things that bite into the profit he said that at a minimum he would have to see 35 patients in a nine hour work day and just maybe break even. Or, he has patients that are on the wait list for surgery that give a far better return. So what does he do? He gives his staff a schedule and the Medicare patients just have to wait or go to another doctor. As he explained; it's not just about the money, it's a matter of survival.

 

[NYlakesider]

A few years back the next in line patient did not show up and the Doc spent extra time with me. Some of it went to the B.S. talk category.

We talked a few subjects and in a general way we started talking money issues/stocks. I mentioned that I was doing reasonably well but far from your tax bracket. He replied you might be surprised about how close in net worth we both might be, you do not have to pay for Male Practice insurance.

 

[AKtinman]

Ahh... The annual Geezer exam.

When I was asked to draw a clock I drew a digital one. Nope, not what she wanted, but she got a good laugh over it.