Wellness visits key for Medicare patients

Yearly health maintenance, preventive care and diagnostic screening form the backbone of primary care medicine. It's one of the most important steps that patients can take to ensure their health and wellness. This is true for patients of any age and level of health, but it's especially true for our Medicare population.

All Medicare beneficiaries are eligible for a Medicare Annual Wellness Visit. This is a yearly visit, covered by Medicare, in which you and your primary care physician have a chance to update your medical history, discuss patient-specific risk factors based on your personal and family medical history, get up-to-date on vaccinations and order age-appropriate diagnostic studies to screen for disease.

Medicare also covers an Initial Preventive Physical Examination, which we often call the "Welcome to Medicare" visit. This is an additional benefit for new Medicare enrollees, and can take place at any point within the first 12 months after enrolling in Medicare Part B. This is a one-time service, and you don't have to do a Welcome to Medicare visit in order to take part in Annual Wellness Visits thereafter. During an IPPE visit, your doctor usually will order blood work to screen for such things as high cholesterol and kidney disease, measure your height and weight to calculate your body mass index, test your visual acuity, measure your blood pressure, perform a physical exam and order referrals to other health care providers, such as an eye specialist or gastroenterologist, if needed. He or she will make sure that you have received all of the appropriate cancer screening tests, such as mammograms and colonoscopies, and make sure that you are up-to-date on all of the appropriate vaccinations, such as the pneumonia vaccine, flu vaccine and shingles vaccine. Other screening tests may include Pap smears for women, bone density scans to screen for osteoporosis, and ultrasounds to screen for abdominal aortic aneurysms if you have certain risk factors.

These visits are also a good time for your physician to talk to you about your risk for depression, your functional status, any safety issues that you may have in the home - and if you might be at risk for developing cognitive decline and dementia. It's also a great time to speak to your physician about advanced care planning and receive assistance with advance directives.

Under current law, you pay nothing for both the Welcome to Medicare Visit and the Medicare Annual Wellness Visit. There is no copay, no co-insurance, and the cost of the visit doesn't count towards your annual deductible. However, if your doctor addresses additional health concerns not covered under your preventive benefits, then copays, co-insurance and deductibles may apply.

When planning your visit, be sure to bring a current list of your medications, your vaccination history, if you have it, and any pertinent past medical records. Having a family member accompany you always can help, especially for advanced care planning. And, to make sure that you don't forget to ask anything, consider writing a list of your questions and concerns ahead of time.

Dr. Blake Garmon is a member of the Sentara Martha Jefferson Internal Medicine care team.

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This column, which promotes community health, is sponsored by Sentara Martha Jefferson Hospital, Region Ten Community Services Board, Thomas Jefferson Health District and the University of Virginia Health System.