Medicare appointments: which office visits are not like the others?

Are you a participant in Medicare Part B insurance? If so, Medicare has defined a few different types of office visits with your primary care providers to optimize your health and quality of medical care.

1. Welcome to Medicare visit

In the first year of your Medicare coverage, you will schedule an introductory visit or Initial Preventive Physical Examination (IPPE). Typically this occurs when you turn 65. Your primary care provider, either physician or nurse practitioner, will review your medical history, current health status and future prevention plans.

In this visit, you can expect:

  • Thorough review of your medical, social and family history
  • Measurement of height, weight, and blood pressure and body mass index calculation
  • Physical exam
  • Administration of necessary screenings (such as mental status exam and fall risk), vaccines, and referrals to appropriate specialized care (for colonoscopy, mammogram or specialists)
  • Hearing and vision screening
  • Discussion of advance directives and living will
  • Development of a care plan for future screenings, vaccines and management of chronic conditions

2. Annual Wellness Visit (AWV)

After your first twelve months with Medicare, you will be eligible to schedule an annual visit, intended to review your health, medical history and to revise your preventative health plan. Prior to your appointment, you will receive a packet of information including the “Health Risk Assessment” that will help your visit be the most productive and beneficial for your long-term health. These appointments may be completed by your primary care provider or a licensed professional; in our office, you will most likely complete this visit with me or Reid’s Medicare Wellness Specialist.

The visit includes:

  • Measurements of height, weight, blood pressure and body mass index
  • Review of current medications, health conditions, past medical history, family medical history
  • Routine screenings: hearing, vision acuity, mental status or memory questionnaire
  • Care plan modification: plan for future health screenings, vaccinations and other preventative health services

The Annual Wellness Visit is intended to be an information gathering session only, so Medicare does not include a physical exam. Therefore, if you have a medical concern that you would like to have addressed, please schedule a separate, additional office visit.

Both the Welcome to Medicare and Annual Wellness Visits are fully covered by Medicare, with the exception of additional tests or screenings added that are not included in the above mentioned list.

3. Office Visits

This category includes your routine appointments for management of chronic conditions and addressing new health concerns. The coverage of office visits is dependent on your specific Medicare plan and may require a copay or additional payment depending on the type of visit and necessary diagnostic testing. Please contact your insurance provider for specific questions concerning service coverage.

I hope to have the pleasure of meeting with you in the future!
Ashley Fox, FNP-C

For more information on Medicare coverage, visit the official website: Medicare.Gov

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