Wellness

[Kachina624]

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@Marp wrote:

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@Kachina624 wrote:

@SilleeMee.  I have an advantage plan and have not paid one penny for insurance, a deductible, or a co-pay since I went on Medicare.   I do pay the annual Medicare fees. So far I've seen 3 specialists and my GP this year and have had 2 blood tests.

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@Kachina624,  you are fortunate to live in an area that offers such expansive Advantage coverage.  However, comparing your Advantage coverage to Advantage coverage of others is apples to oranges.

Unlike Medicare, which has the same benefits for everyone, Advantage plans can be night and day even within the same carrier and classification.

I have decent Advantage coverage compared to a family member that lives in an adjacent county and is with the same insurer; we both have PPO policies but different coverage, co-pays, drug formularies and even in network participants.

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 @Marp.  I think an Advantage contract with  entities  is probably contigent on the contract they're able to negotiate with the insurers.  I'm betting large groups get the best deals.

[granddi]

The answer to the question about Medicare coverage of blood work has been answered in this discussion.

It is not a matter of Traditional vs Advantage. 

It doesn't matter if my doctor ordered it.

It matters what medical code is given to the test or proceedure.

A code of Routine, Preventative or Wellness cannot be used or the cost of the blood work will be your responsibility. There must be a medical conditon to justify testing and coded accordingly.

If your appointment is for a Medicare Wellness -this is not a problem focused appointment. It is a screening, wellness appointment. When I make my appointment I always tell them "this is NOT my Medicare Wellness Visit" 

[Still Raining]

Do they also offer a timeshare on some oceanfront property?????

SCAM!

[CelticCrafter]

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@PA Mom-mom wrote:

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@SilleeMee wrote:

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@PA Mom-mom wrote:

How is this different from the normal blood work we get every year as part of our check-up?

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@PA Mom-mom 

A 'Wellness Visit' through Medicare? Mine have never covered blood tests. If I ask for one then I'm charged for it.

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@SilleeMee My Medicare insurance requires and pays for blood work once a year as part of Medicare coverage. Are we talking about the same thing?

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Medicare does not require any kind of testing.  

A Wellness Visit is not the same as an annual physical and annual physicals are not covered by Original Medicare.

[wagirl]

I have never head of dry blood analysis. I get blood work done every 3-6 months mostly for lipids and then 1 complete lab a year. and all are covered.

[smoochy]

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@CelticCrafter wrote:

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@PA Mom-mom wrote:

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@SilleeMee wrote:

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@PA Mom-mom wrote:

How is this different from the normal blood work we get every year as part of our check-up?

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@PA Mom-mom 

A 'Wellness Visit' through Medicare? Mine have never covered blood tests. If I ask for one then I'm charged for it.

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@SilleeMee My Medicare insurance requires and pays for blood work once a year as part of Medicare coverage. Are we talking about the same thing?

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Medicare does not require any kind of testing.  

A Wellness Visit is not the same as an annual physical and annual physicals are not covered by Original Medicare.

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and the Medicare Wellness screening is optional. My husband and I politely decline when its offered. We dont need yet another appointment on the calendar especially one that is unnecessary and optional. Even though it can be done by phone. 

[smoochy]

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@SilleeMee wrote:

Dry blood analysis is not FDA approved so it will not be covered by any insurance. The results cannot be be used to validate any health condition nor can the results be used to determine a treatment plan for any health problem diagnosed by a doctor. Imo it's a scam.

I'm a retired lab tech with specialist training in chemistry and hematology. I know about real blood testing and dry blood analysis is not real science.

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Do you have a PhD? Are you a chemist? I feel like I read that in one of your posts a while back. Maybe I dreamed it lol

[SilleeMee]

@smoochy 

I have MS in biochemistry. I was a specialist in chemistry and hematology in the department of pathology where I worked at a hospital. 'Specialist' is a lab certification where continuing ed classes are accrued and credits applied for attaining the specialist certification. It's sort of a master degree of sorts but applicable in diagnostic medicine in the lab.

[smoochy]

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@SilleeMee wrote:

@smoochy 

I have MS in biochemistry. I was a specialist in chemistry and hematology in the department of pathology where I worked at a hospital. 'Specialist' is a lab certification where continuing ed classes are accrued and credits applied for attaining the specialist certification. It's sort of a master degree of sorts but applicable in diagnostic medicine in the lab.

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ah thanks for clarifying 😊