Welcome to Medicare Visit
The Medicare Prescription Drug, Improvement and Modernization Act of 2003 (MMA) expanded Medicare's menu of preventive benefits by covering an initial preventive physical examination. This benefit, also referred to as the "Welcome to Medicare" visit, is an excellent way for new Medicare beneficiaries to get up-to-date on important screenings and vaccinations, as well as to talk with their health care provider about their medical history and how to stay healthy.
All beneficiaries enrolled in Medicare Part B with effective dates that begin on or after January 1, 2005, will be covered for this benefit. Beneficiaries can only take advantage of this one-time within their first six months of Medicare Part B coverage, so it is very important that beneficiaries make an appointment with a health care provider right away.
What is Included?
The Welcome to Medicare visit is a comprehensive examination consisting of the following seven components:
1. A review of an individual's medical and social history with attention to modifiable risk factors
2. A review of an individual's potential risk factors for depression
3. A review of the individual's functional ability and level of safety
4. An examination to include an individual's height, weight, blood pressure measurement, and visual acuity
5. Performance of an electrocardiogram (EKG) and interpretation of the EKG
6. Education, counseling, and referral based on the results of the review and evaluation services described in the previous five components
7. Education, counseling, and referral, including a brief written plan such as a checklist for obtaining the appropriate screening and/or other Medicare Part B preventive services
It is important to note that the benefit will not reimburse you for clinical laboratory tests. Your patient will pay 20 percent of the Medicare-approved amount after meeting the yearly Part B deductible. Since this may be the beneficiary's first Medicare covered service, the beneficiary may meet the entire Part B deductible at this visit.
Links
"Getting Paid: How to Conduct a 'Welcome to Medicare' Visit" - from the American Academy of Family Physicians
Welcome to Medicare Documentation Tool (PDF) - from the American Academy of Family Physicians
Overview: Welcome to Medicare Visit - from the Centers for Medicare & Medicaid Services
The Guide to Medicare Preventive Services (PDF) - from the Centers for Medicare & Medicaid Services