Medicare Part B offers a “Welcome to Medicare” preventive healthcare visit to all new enrollees. During this visit, a doctor reviews an individual’s current state of health and medical history and offers information and advice. The visit is not a physical.
This article discusses what the “Welcome to Medicare” visit covers, the differences between this visit and annual wellness visits (AWVs), and other forms of preventive care that Medicare provides.
When a person enrolls in Medicare Part B, they have the option of scheduling a “Welcome to Medicare” preventive visit. This one-time health check is optional and can take place at any time during the first 12 months of joining Medicare.
During this visit, a person meets with their primary care provider to discuss their medical history and any health concerns. The doctor will take measurements, perform certain health tests, and, if necessary, create a care plan. The goal of this visit is to promote wellness and prevent future illness by highlighting risk factors.
Medicare Part B completely covers the cost of the “Welcome to Medicare” visit if a person uses a participating healthcare professional.
There is no deductible or coinsurance. However, if the doctor needs to treat a new or existing condition or perform additional tests during the visit, Medicare may charge for this.
The “Welcome to Medicare” visit is not the same as a detailed annual physical exam. Medicare parts A and B do not cover this kind of health service.
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The “Welcome to Medicare” visit is an initial consultation that provides the doctor with baseline measurements for monitoring a person’s health.
Healthcare professionals use these initial measurements for comparison in subsequent annual wellness visits (AWVs) and other appointments to assess health status over time.
During the visit, the doctor will take a range of measurements, including:
- blood pressure
- heart rate
- height
- weight
- body fat
- body mass index (BMI)
- respiration rate
- vision
The doctor will also assess the person’s mental health and their ability to function safely in the home and wider community.
In addition to this basic examination, the doctor will also ask questions about family and personal medical history.
These questions may cover:
- previous illnesses, conditions, or surgical procedures
- diseases or conditions that family members have experienced
- lifestyle factors, such as diet, exercise, smoking, and alcohol use
- any current medications and dietary supplements
This information allows the doctor to determine any risk factors for future illnesses or conditions. They can then recommend appropriate screening measures or further tests.
During the “Welcome to Medicare” visit, a doctor can also schedule appointments for routine preventive care, including:
- cancer screenings
- immunizations
- male and female health checks
Depending on an individual’s needs, the doctor also may provide information and guidance about specific health conditions or referrals to other healthcare professionals.
Typically, the doctor will also talk with the person about advance directives. An advance directive is a legal document that contains information about the healthcare that someone would want to receive if their illness or condition prevented them from speaking for themselves or making their own decisions.
Usually, a person will select someone to make medical decisions on their behalf. Creating an advance directive helps ensure that healthcare professionals understand an individual’s future healthcare wishes.
Both the “Welcome to Medicare” visit and the AWVs aim to keep track of an individual’s health. They are similar health assessments, but they are separate services.
The “Welcome to Medicare” physical only takes place during the initial 12 months of enrolling. It is an optional, one-time health assessment.
After someone has had Medicare Part B for more than 12 months, they are entitled to one AWV each year. During these visits, the person will complete a “Health Risk Assessment” test.
The doctor may also perform a cognitive assessment to look for any early signs of Alzheimer’s disease or dementia.
The doctor will use all this information to form a personalized illness prevention plan. The goal of this plan is to prevent future illnesses or conditions based on a person’s health and potential risk factors.
On each subsequent AWV, the doctor and the individual will update the illness prevention plan to include any new information. The plan evolves with the person to uphold their health needs.
An individual does not have to pay for an AWV. There is no Part B deductible. However, as with the “Welcome to Medicare” visit, if the doctor orders additional tests or services, there may be coinsurance, and the Part B deductible may apply.
Preventive care aims to prevent disease. It helps detect health concerns so that a person can seek treatment before a condition causes issues.
Medicare covers a range of preventive services and screening tests.
Screening tests include those for:
- abdominal aortic aneurysm
- bone mass
- cancer
- cardiovascular disease
- depression
- diabetes
- glaucoma
- hepatitis B and C
- HIV
- obesity
- sexually transmitted infections (STIs)
Medicare also covers some vaccinations, including those for:
- hepatitis B, for people at medium or high risk
- influenza
- pneumococcal disease
- COVID-19
People enrolled in Medicare can also access a range of counseling services, therapies, and lifestyle training, including:
- alcohol misuse counseling
- cardiovascular disease behavioral therapy
- diabetes self-management training
- nutrition therapy services
- obesity counseling
- STI counseling
- tobacco use counseling
The “Welcome to Medicare” visit takes place during the first year of a person’s Medicare Part B coverage. It offers the individual an opportunity to discuss their state of health with their doctor and create a preventive healthcare plan.
Medicare covers the cost of this visit but does not cover additional laboratory tests or any necessary treatments.
Medicare may also cover routine vaccinations, certain screening tests, and other preventive measures.
