Medicare covers a one-time, initial examination (also known as the Welcome to Medicare preventive visit) within the first 12 months you enroll in Part B. All people new to Medicare qualify for this visit.
The Welcome to Medicare preventive visit includes:
- Review of medical and social history
- Review of potential for depression or other mental health conditions
- Review of ability to function safely in the home and community
- Check of your height, weight and blood pressure, and body mass index and vision test
- Education, counseling and referrals related to risk factors and what the doctor found during the visit
- Education, counseling and referrals related to other preventive services covered by Medicare. This includes a written plan created by your provider. A checklist is an example of a written plan your doctor may give you.
- Discussions about health care advance directives
- Health care advance directives are legal documents that typically allow you to appoint someone to act for you and to identify what medical treatment you want if you can no longer make health care decisions yourself.
- An electrocardiogram (EKG) may also be included in a Welcome to Medicare visit. However, Part B deductibles and coinsurances will apply.
- As a result of the Welcome to Medicare visit, you may receive a referral for an Abdominal Aortic Aneurysm (AAA) screening. If you receive a referral because you are at risk for an AAA, Medicare should cover an AAA ultrasound with no deductible or coinsurance. This is true if you see a health care provider who accepts assignment.
- The Welcome to Medicare preventive visit is not a head-to-toe physical.
Starting January 1, 2011, Original Medicare covers the Welcome to Medicare preventive visit with no coinsurance or deductible if you see providers who take assignment. Doctors and other health care providers who take assignment cannot charge more than the Medicare approved amount.
Note: If you receive any additional services or screenings during the Welcome to Medicare preventive visit, then you may have an additional charge for those services. Services not included in the Welcome to Medicare visit will be billed separately. You may be charged your usual copay and deductible if the additional service is covered by Medicare.
If you are in a Medicare Advantage plan, you should check with your plan to see what rules and costs apply. Starting in 2012, Medicare Advantage (MA) plans will cover all preventive services the same as Original Medicare. This means MA plans will not be allowed to charge cost-sharing fees (coinsurances, copays or deductibles) for preventive services that Original Medicare does not charge for as long as you see in-network providers. If you see providers that are not in your plan’s network, charges will typically apply.