Wellness

[goldensrbest]

I had my first visit to the doctor in july ,under the medicare plan i turned 65 last december,i got papers from them yesterday ,saying my annual visit,and two vaccines were not covered,shingles,and tentanus, dipthera, i have test i need done ordered by doctor,will these be covered ,how to know.What did i do wrong?

[jackthebear]

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@goldensrbest wrote:

I had my first visit to the doctor in july ,under the medicare plan i turned 65 last december,i got papers from them yesterday ,saying my annual visit,and two vaccines were not covered,shingles,and tentanus, dipthera, i have test i need done ordered by doctor,will these be covered ,how to know.What did i do wrong?

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ask your Dr. 

shingle vac  is usually not covered,  however if you get shingles the RX costs more than the vax 

[on the bay]

@goldensrbest-

I remember reading about this and how confusing it was!

There is something like a wellness visit that is covered but an "annual physical" is not or something stupid like that! Its all in the wording.

I would call medicare to make sure or your doctor's office but sometimes the person answering the phone doesn't even know for sure.

You also could ask your doctor's office to change the coding of this visit so it can be covered!

[jackthebear]

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@on the bay wrote:

@goldensrbest-

I remember reading about this and how confusing it was!

There is something like a wellness visit that is covered but an "annual physical" is not or something stupid like that! Its all in the wording.

I would call medicare to make sure or your doctor's office but sometimes the person answering the phone doesn't even know for sure.

You also could ask your doctor's office to change the coding of this visit so it can be covered!

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yes   coding

[Cakers3]

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@goldensrbest wrote:

I had my first visit to the doctor in july ,under the medicare plan i turned 65 last december,i got papers from them yesterday ,saying my annual visit,and two vaccines were not covered,shingles,and tentanus, dipthera, i have test i need done ordered by doctor,will these be covered ,how to know.What did i do wrong?

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@goldensrbestThis shot is covered by Medicare.  See Medicare.gov-it is the tdap vaccine.

Are you on just Medicare or do you also have an advantage or supplemental plan?

Your annual visit should be a co-pay or no co-pay determined by what type of coverage you have.

[SilleeMee]

Coding must be entered for "wellness" not just annual or annual physical checkup/exam. The shingles vaccine is covered under Part D but varies according to your particular plan and where you purchased/received the actual vaccination.

[Cakers3]

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@on the bay wrote:

@goldensrbest-

I remember reading about this and how confusing it was!

There is something like a wellness visit that is covered but an "annual physical" is not or something stupid like that! Its all in the wording.

I would call medicare to make sure or your doctor's office but sometimes the person answering the phone doesn't even know for sure.

You also could ask your doctor's office to change the coding of this visit so it can be covered!

---

@on the bay@goldensrbest

The wellness visit is the "Welcome to Medicare" visit (oh yay) where you go over Medicare with your physician.  That is covered with no charge. 

Your annual visit, or annual physical visit, is covered but depending upon what advantage/supplemental plan you might have your co-pay could be applicable. Some plans have no co-pay.

The coding is key but you also have to make sure what type of visit you are seeking and ask for it.  Never assume that anybody in billing is on top of the game.  Never.

And I speak from personal experience. 

[SilleeMee]

You get a one-time-only "Welcome Wellness" visit plus the regular wellness visit. Both are covered under Medicare. Physical exams or annual checkups are not covered.

[Cakers3]

Also the "Welcome to Medicare" visit is a one-time only when you are enrolled.

@goldensrbest

[Bella2022]

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@Cakers3 wrote:

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@on the bay wrote:

@goldensrbest-

I remember reading about this and how confusing it was!

There is something like a wellness visit that is covered but an "annual physical" is not or something stupid like that! Its all in the wording.

I would call medicare to make sure or your doctor's office but sometimes the person answering the phone doesn't even know for sure.

You also could ask your doctor's office to change the coding of this visit so it can be covered!

---

@on the bay@goldensrbest

The wellness visit is the "Welcome to Medicare" visit (oh yay) where you go over Medicare with your physician.  That is covered with no charge. 

Your annual visit, or annual physical visit, is covered but depending upon what advantage/supplemental plan you might have your co-pay could be applicable. Some plans have no co-pay.

The coding is key but you also have to make sure what type of visit you are seeking and ask for it.  Never assume that anybody in billing is on top of the game.  Never.

And I speak from personal experience. 

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I wouldn't  say or something stupid like that, it's about your health!!