What is covered in the free yearly physical provided by Medicare?

2 answers | Last updated: Oct 07, 2016
A fellow caregiver asked...

When Medicare says a yearly physical is offered with no payment by patient, what is covered in the physical?

Expert Answers

Medicare calls its new (beginning in 2011) annual physical exam the Wellness Exam. It's a special physical exam specifically designed for the needs of people 65 and older. You're entitled to one "Welcome to Medicare" initial wellness exam within the first 12 months after you first enroll in Medicare Part B, then one annual wellness exam thereafter. Medicare pays the full cost of these exams.

The wellness exam is a lot like any other annual physical, except it focuses not only on what your current condition and complaints are but also on screenings (such as for cancers) and other preventive services (such as vaccinations) you might also need. As with any other physical exam, you should tell your doctor of any problems or complaints you have, so that the doctor can check them and treat them or order further testing as necessary. But the doctor will also talk to you about certain screenings and other preventive services that you might need simply because of your age and family history, regardless of any current symptoms you have. A Medicare wellness exam also includes the doctor doing an assessment of possible cognitive impairment -- meaning whether you show any of the early signs of Alzheimer's or other dementia.

At the end of each wellness exam, the doctor is supposed to write up a plan for you that spells out the screenings and other preventive services you should obtain. Finally, the doctor is supposed to discuss end-of-life health care planning with you, meaning whether you have an advance health care directive (also called a living will or power of attorney for health care).

Community Answers

Teri3456 answered...

My physician just charged me for my annual physical. He submitted charges of $130 for physical, which medicare and my supplemental covered. He also submitted $95 for a level 3 visit and $20 for telling me to stop smoking, neither of these charges were covered by either medicare or my suppl