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Old 09-22-2019, 10:42 AM
 
Location: SoCal
14,272 posts, read 6,870,254 times
Reputation: 11089

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I got called from my BCBS to go for check up, I’m not even on Medicare yet.
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Old 09-22-2019, 12:59 PM
 
Location: SoCal
6,106 posts, read 9,678,697 times
Reputation: 5891
Quote:
Originally Posted by Travelassie View Post
No it's not mandatory. Medicare patients can refuse anything they want.

Interestingly, though, it may be that your PCP or other provider might be pressured by Medicare to encourage their patients to have the annual wellness visit, the screening tests or what have you. The providers are expected to provide ongoing documentation that they have done so, as well as documentation of followups for results and findings. Failure to do so at a high enough rate will result in Medicare decreasing the reimbursement amount for failure to "meet the standards of quality care as determined by the CMS bean counters. Providers can document the patient's refusal for any test, physical, screening or survey, but they have to ask or offer it to the patient.
My PCP said the same. It was procedure for her to tell me about it. I'm a medical-phobe and my PCP is a genius at helping me cope with it. She described the wellness exam, and I told her that sounded absolutely dreadful. She chuckled, knowing that would be my response. Win-win for both of us. She's expected to offer it and she did, and I'm able to refuse it and I did.
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Old 09-22-2019, 01:11 PM
 
728 posts, read 227,063 times
Reputation: 1446
Quote:
Originally Posted by oddstray View Post
My PCP said the same. It was procedure for her to tell me about it. I'm a medical-phobe and my PCP is a genius at helping me cope with it. She described the wellness exam, and I told her that sounded absolutely dreadful. She chuckled, knowing that would be my response. Win-win for both of us. She's expected to offer it and she did, and I'm able to refuse it and I did.
Sounds just like my PCP. We both laughed. She knew there was no way I was going to be answering many of those invasive questions. When she told me about how concerned medicare was about falls, I just laughed and said I guess we better not tell them about the horses.
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Old 09-22-2019, 04:30 PM
 
7,291 posts, read 4,021,861 times
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You can't get a general checkup covered by Medicare until after Part B has been active a full year?
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Old 09-22-2019, 05:15 PM
 
Location: OH>IL>CO>CT
5,373 posts, read 8,685,482 times
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Quote:
Originally Posted by bpollen View Post
You can't get a general checkup covered by Medicare until after Part B has been active a full year?
During (or ideally at the start of) the first year, you can get a "Welcome to Medicare" visit. Then each year after its a "Annual Wellness Visit". Both are "free". Neither are "physicals"

However if any procedures are done during these visits, charges may apply.

See pages 48 & 49 of https://www.medicare.gov/sites/defau...-and-you_0.pdf for more details.
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Old 09-22-2019, 10:18 PM
 
26,588 posts, read 33,624,402 times
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So Medicare does not cover an annual physical. Well that sucks. This is new information to me (I have a couple of years to go) and I have had an annual physical every year for at least 25 years. It seems weird to expect people to simply stop getting physicals...kind of counter-productive. How do people get coverage for an annual physical?
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Old 09-23-2019, 01:05 AM
 
81 posts, read 33,202 times
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Quote:
Originally Posted by ChessieMom View Post
So Medicare does not cover an annual physical. Well that sucks.
I had a Welcome To Medicare visit a few months ago, this is my first year on Medicare. They say "it's not a physical" but my WTM visit with my regular doc was exactly like every other annual exam I've ever had from her: height, weight, BP, skin check, breast exam, PAP, listen to heart and lungs, looked down my throat, referred me for mammogram, DEXA scan, routine blood work. (I wasn't due for colonscopy, was up to date on my vaccines.)

I didn't have to pay anything for any of this. (The blood work you can only get every 5 years covered by Medicare.)

I have read a lot about the WTM visit on this forum and read what Medicare writes about it, but truth is it seems to depend on the specific doctor what they do. Mine was a regular annual wellness exam (not sure what's different about it than a "physical".)

I didn't have to answer any invasive questions, draw a clock face, remember 3 words or anything of that nature.
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Old 09-23-2019, 06:28 AM
 
2,617 posts, read 959,237 times
Reputation: 6852
Quote:
Originally Posted by Jessie Mitchell View Post
(The blood work you can only get every 5 years covered by Medicare.)
Wow- no wonder my bloodwork got kicked back as not medically necessary". I agree with ChessieMom- this seems counter-productive. To me, the bloodwork is a good source of info on what might be going wrong. I'm grateful I can foot the bill myself and order it on-line for under $100.

Quote:
I didn't have to answer any invasive questions, draw a clock face, remember 3 words or anything of that nature.
The clock face is an interesting test; when DH was in his last months he appeared confused at one point and I asked him to draw a clock face with numbers. I'd heard from a relative who was a psychiatrist that that was a good test of cognitive skills because it required some planning and organizing. DH's was a mess. I was horrified. I actually saved it for awhile Fortunately the confusion passed- maybe it was some of his meds interacting.

My doc didn't ask me to do any of those, either, but I think it was pretty clear to her that I didn't have any mental impairments.
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Old 09-23-2019, 08:46 AM
 
Location: SoCal
14,272 posts, read 6,870,254 times
Reputation: 11089
The clock test I’ve read from the book from Dr Mary Newport, her husband had early case of AZ. I think he got it at age 50-55 and died at age 65.
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Old 09-23-2019, 08:48 AM
 
26,588 posts, read 33,624,402 times
Reputation: 33431
Quote:
Originally Posted by Jessie Mitchell View Post
I had a Welcome To Medicare visit a few months ago, this is my first year on Medicare. They say "it's not a physical" but my WTM visit with my regular doc was exactly like every other annual exam I've ever had from her: height, weight, BP, skin check, breast exam, PAP, listen to heart and lungs, looked down my throat, referred me for mammogram, DEXA scan, routine blood work. (I wasn't due for colonscopy, was up to date on my vaccines.)

I didn't have to pay anything for any of this. (The blood work you can only get every 5 years covered by Medicare.)

I have read a lot about the WTM visit on this forum and read what Medicare writes about it, but truth is it seems to depend on the specific doctor what they do. Mine was a regular annual wellness exam (not sure what's different about it than a "physical".)

I didn't have to answer any invasive questions, draw a clock face, remember 3 words or anything of that nature.
My physicals, for the past 10 years, include a full CBC. They had noticed a low WBC and wanted to test further. Everything eventually turned out to be fine..but the dr has wanted me to get a CBC each year since. I don’t think that a “well visit” would include the same tests. I have seen the lab charges on the insurance claim. The insurance covers the labs completely - no copay. It paid 52.48, on a total claim of $680.00.

The dr’s charge was 252.00. And that was paid at 162.51.

That’s nearly $1000. Which is insane of course. But with insurance I really am not impacted by these ridiculously inflated costs. So that’s why I’m asking. How do people get coverage for an annual physical? A *true* physical...not just some “hey how ya feelin’” visit.

Last edited by ChessieMom; 09-23-2019 at 09:00 AM..
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