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How does Medicare work? Does Medicare cover physical exams? Will Medicare pay for annual exams? Are lab tests covered? Watch our videos
Let's review what original Medicare covers with regard to annual exams.
Your Welcome to Medicare #exam is available at no charge to you. The exam must be done within the first 12 months following the start of Medicare Part B. Your doctor should know what is covered as well as how to properly code the exam so you have no out of pocket expenses.
Thereafter you are entitled to a Medicare Annual Wellness Visit. Again, your doctor should know what is covered and how to code the exam.
This is a wellness exam, not a diagnostic visit. Your doctor may ask you to complete a form that asks about medical problems you may be experiencing. That is within the norm and should be expected.
Your doctor may also conduct cognitive screening tests or the "Get up and go" test to check for mobility issues.
Some lab tests or other diagnostic screenings may incur an out of pocket charge. In that case your doctor may have you sign an ABN (Advance Beneficiary Notification) form. By signing the form you agree to pay for any testing that is not approved by Medicare. You and your doctor should discuss whether or not you believe the test is necessary and if you are willing to pay for the test should Medicare deny the claim.
IF YOUR DOCTOR does not have you sign the ABN and your claim is denied, you DO NOT OWE the doctor or lab. This is a consumer protection that only exists with ORIGINAL MEDICARE.
ABN (Advance Beneficiary Notification)
Welcome to Medicare Exam – Annual Wellness Visit
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