Wellness

[SeaMaiden]

@SilleeMee  Thank you for the explaination. I totally believe in PREVENTION and taking care of your health.

[Caligurll]

On page 60 of the 2017 Medicare and You booklet it says after you have had Medicare for longer than 12 months a yearly Wellness visit is covered.

[Caligurll]

Page 56 of Medicare and You says the shingles shot is not covered under Parts A and B, but is covered under part D.

[SilleeMee]

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@Caligurll wrote:

Page 56 of Medicare and You says the shingles shot is not covered under Parts A and B, but is covered under part D.

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Yes, this will apply but varies according to your particular drug plan. Some pharmacies or clinics where the vaccination is given may charge you if they are not included your health plan's network of providers. Sometimes it can be difficult to determine which ones are within your network. So it's best to ask the person giving you the actual shot if it is covered under your plan and then they can verify it beforehand.

[hckynut]

@goldensrbest

I don't know specifically about the coverage for the things you listed, but I do know that there usually is no 1 single answer. Could be the visit doctor services were coded wrong. Unfortunately there are now many doctors that do not except Medicare patients. I had one that changed after the *** came to reality, and I had to find a new doctor.

I personally would talk with the doctor's office staff member that is in charge of the Insurance and get that explanation. If not satisfied, move on up the chain in your city and get answers. 

Medical Insurance, yes Medicare, seems confuse even those that work in that business. There are differences in Supplemental Insurance, and seems, in my many experiences, like very few really understand all the complexity involved with much of it.

I have spent the best part of some days discussing many of my bills with different people in different capacities getting my EOB's corrected to be in line with my Medicare and my Supplemental Insurance.

Money I pay out is more important to me than how much time I have to spend to get it done correctly, and to the penny. There is no "that's the way your insurance works" reply that is gonna fly with me. With me it is details/details/details.

hckynut(john)

[goldensrbest]

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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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I called medicare ,and doctor ,yes the first 12 months ,your only allowed a medicare welcome ,not a wellness apointment ,crazy.

[BLH]

Medicare does not pay for a routine eye exam or refraction either.  They will pay for an eye exam if you have something medically wrong with you that affects your eyes.  They never pay for a refraction.  Advantage plans are different for eye exams.  Some people think that medicare pays for everything and they don't.

[kitcat51]

@goldensrbest The info you gave between the Medicare welcome & the wellness appt is very interesting. I've been pestered with phone calls since I enrolled a few months ago to make a wellness appt which I declined because I still have the same Dr, I see her every six months & I'm up to date on everything so I don't need it. The calls keep coming sometimes twice a week & I've explained it over & over so to find out the wellness is not covered until after a year makes it even more maddening. I'm all about cutting costs & wish Medicare & all health insurance was less confusing. Honestly, most people these days don't even know what their doctors visit cost only their copay. If we had competition with all costs listed up front for Drs, hospitals & lab work it would reduce costs, you would go where you got the most for your money making those providing the services provide the best care or be left in the dust but that would be too simple. Keeping it the way it is picks your pocket.

[millieshops]

@Cakers3I agree. Paper trails are so important. With computers and emails so prevalent, some forget that.  I still have all the correspondence from the mess I mentioned and that was 4 years ago.  I don't trust them not to circle back and try again, so I operate as if they're the IRS with its 7 year lookback possibilities.

[software]

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@hoosieroriginal wrote:

Really seems silly not to cover an annual exam each year.  I would think the insurance would appreciate more wellness visits than people waiting until they are really sick before seeing a doctor.  There should be regular checkups, bloodwork, to keep people over 65 healthy and aware what is going on.  I've just never understood their mentality.

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For what you just explained, makes me think that it's all more about tracking people, not providing medical care.