Published on May 31, 2021

Why It's Important to See Your Doctor Every Year

mature woman

Seeing your primary care provider every year, even if you are not feeling bad, is important for health maintenance.

Why is it important to see your doctor or nurse practitioner every year?

We all remember the old adage: an ounce of prevention is worth a pound of cure. This is the concept that forms the foundation for all wellness visits.

Seeing your primary care provider every year, even if you are not feeling bad, is important for health maintenance.

A yearly annual exam can help detect signs and symptoms of disease early, which allows for early intervention.

An annual exam also allows time to perform health screening. These will depend on age, gender, personal history and family history. Examples include PSAs, mammograms, pap smears, colonoscopies, abdominal aortic aneurysm screenings, lung cancer screenings, blood pressure checks, glucose checks and cholesterol checks.

An annual exam is also a great time to catch up on vaccines that are appropriate and due.

Annual exams allow time to discuss any unhealthy habits (tobacco use, obesity, alcohol overuse, illicit drug use) and address those.

Annual exams also allow time to assess your mental health and stress levels.

What is a Medicare Wellness Visit and what is included?

Medicare Wellness Visits are divided into two components:

  • Cognitive Assessment-- checks for early signs of dementia and mood disorders, such as Alzheimer’s disease and depression.
  • Personalized Prevention Plan-- your health care provider will consider your cognitive assessment, personal history, age, gender, family history, vital signs and develop an appropriate plan for disease prevention. This may include vaccines, screening tests, diet intervention, tobacco cessation plan, exercise plan, fall prevention plan, or any other tests that your provider feels will help keep you healthy.

Is there any cost to the individual for a Medicare Annual Wellness Visit?

If you have Medicare Part B and your health care provider is able to bill Medicare, there is no cost to you. The Part B $200 deductible does not apply, nor does the 20% copay. It costs you nothing.

We, as health care providers, do bill Medicare for these services. Medicare reimburses the charge at 100%.

How does a Medicare Wellness Visit differ from a wellness visit covered by other insurance companies?

The Medicare Annual Wellness Visit differs from other wellness visits in a couple of ways:

  • The Medicare Annual Wellness Visit is not on a calendar year time frame, meaning you have to wait a full year from your last wellness visit before you qualify for another one. Other insurance companies allow wellness exams based on calendar year. An example is if you have a Medicare Annual Wellness Visit on Dec. 1, 2020, you will not qualify for another Medicare Annual Wellness Visit until Dec. 2, 2021. Some other insurance companies would allow you to have a wellness exam on Dec. 1, 2020, and be eligible for another wellness exam on Jan. 1, 2021, because these are different calendar years.
  • There are no physical exam nor lab work requirements included in the Medicare Annual Wellness Visit. Most other insurance companies want a documented head-to-toe physical exam and some blood work, usually a glucose and a lipid panel, to be done at the time the wellness exam is performed. Medicare does not. The only requirements of the Medicare Wellness Visit are the cognitive assessment and the personalized prevention plan.
  • Medicare Annual Wellness Visits can be combined with a “problem” or routine visit. I rarely do a Medicare Annual Wellness Visit only. I find it is easier for me and for the patient to combine the components of the annual wellness visit with what I normally do for a routine checkup. Most other insurance companies will not allow a wellness visit and a “problem” visit on the same day, but Medicare does.

What screening tests are done?

The screening tests we order depend on several factors: personal history, age, gender and family history. For example, most people qualify for a colon cancer screening test called a colonoscopy once they reach age 50. Others may need this test earlier depending on family history and personal history. People of a certain age who have a smoking history qualify for a free lung cancer screening. Women of a certain age qualify for free mammograms, and men of a certain age qualify for free prostate cancer checks.

Screening tests are free to the patient. The Part B $200 deductible does not apply, nor does the 20% copay.

How would I find out my test results?

Because we order the tests, we will notify you of your results even if the test is not performed in our clinic. Patients are informed of their results in different ways, depending on what I feel is most appropriate. Sometimes we call the patient with results, sometimes we send a letter, and other times we bring the patient back in to discuss test results if further intervention is needed.

What about virtual visits?

We have the capability of performing virtual visits and phone visits. Patients who have access to a computer or a smart phone can do virtual visits, where we can see and hear each other on the computer or phone screen. When we perform telephone visits, we just talk over the phone.

Medicare Annual Wellness Visits can be performed virtually, over the phone or in person.

How has the pandemic changed in-person visits?

We require a face mask to be worn at all times when in the clinic. We have sectioned off certain areas in the front lobby and in the lab waiting to allow for social distancing. We try to separate our “sick” patients and our “well” patients by seeing them in different areas of the building. We clean each room thoroughly after each patient. We also clean X-ray equipment after each patient. This is necessary to keep people well, even if it slows the flow of the clinic down a little.