Alzheimer's Foundation of America
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Government Programs

Medicare Annual Wellness Exam

The Patient Protection and Affordable Care Act, also known as “Health Care Reform,” signed into law in 2010 makes a few upgrades to Medicare with a focus on prevention and early detection.

The Facts:

  • Starting in January 2011, Medicare will now pay for a wellness exam once every 12 months for beneficiaries.
  • There are no deductibles or co-payments for this visit.
  • The exam includes the creation or update of a personalized prevention plan based on your current health and risk factors.
  • The exam also includes the detection of any cognitive impairment.
  • The visit may be performed by a doctor or any other healthcare provider recognized by Medicare.

More Details About the Detection of Any Cognitive Impairment:

  • Your doctor may do an assessment of your cognitive function through direct observation while also taking into consideration any concerns raised by you, your family, caregivers or others.
  • The detection of a cognitive impairment is not necessarily a diagnosis of Alzheimer’s disease. Some memory problems can be readily treated, such as those caused by vitamin deficiencies or thyroid problems. Other memory problems might result from causes that are not currently reversible, such as Alzheimer’s disease. If your practitioner suspects a problem, additional tests can be run to more accurately determine the cause of the impairment.
  • If you have questions or concerns about your memory, don’t hesitate to ask your doctor or other healthcare professional during this visit or at any other time.

 

What Else to Expect During the Visit:

  • A review of your personal medical and family history, current health conditions and medical concerns, and current prescription drugs, over-the-counter drugs, vitamins and supplements.
  • A check of your blood pressure, vision, weight and height to establish a baseline for future comparison.
  • Discussion of the status of your cancer screenings, shots and other preventive screenings and services.
  • Recommendations for further tests, depending on your general health and medical and family history. Note: Further tests or doctors’ visits not included in the annual wellness exam may require some out-of-pocket costs. Ask your doctor or Medicare if you have questions about coverage.
  • Creation or updating of a personalized prevention plan, including a checklist of suggested screenings, immunizations and other preventive services.

Preparing for the Visit:

  • Bring your medical records, including immunization records, and your family medical history, which can help your doctor determine suggested screenings.
  • Bring a list of any prescription drugs, over-the-counter drugs, vitamins and supplements that you currently take, noting the conditions they related to, dosage and any side effects. Also consider bringing the actual pill bottles.
  • Notify your doctor if you have exhibited any of the following symptoms of dementia or prepare a list of your own concerns:

-Memory loss, especially of recent events, names, placement of objects and other new information

-Confusion about time and place

-Struggling to complete familiar actions, such as brushing teeth or getting dressed

-Trouble finding the appropriate words, completing sentences and following directions and conversation

-Changes in mood and personality, such as increased suspicion, rapid and persistent mood swings, withdrawal and disinterest in usual activities

-Difficulty with complex mental assignments, such as balancing a checkbook or other tasks involving numbers

In Order to Qualify for the Visit:

  • You must have been receiving Medicare Part B benefits for at least 12 months.
  • If you have had your initial, one-time “Welcome to Medicare” physical exam within the past 12 months, you will be eligible for your first annual wellness exam one year from the date of that initial visit.
  • You are eligible for a wellness exam once every 12 months.

To learn more about Medicare, click here.

For more information, connect with the Alzheimer’s Foundation of America’s licensed social workers. Click here or call 866.232.8484. Real People. Real Care.