Understanding Your Medicare Benefits

by Dr. Diana Hayslip

Under the Affordable Care Act that became effective Jan. 1, 2011, Medicare patients receive many preventive services for free if performed by a health care provider who accepts Medicare assignments.

During the first 12 months of enrollment in Medicare Part B, individuals are eligible for a free, one-time Welcome to Medicare preventive visit.

“The Welcome to Medicare preventive visit is a wonderful opportunity for medical providers to understand their patient’s medical history and to establish a baseline for future health care evaluations,” said Cheryl Lewis, APRN who performs these preventive visits for Family Practice Associates of Lexington.

Issues covered during the Welcome to Medicare preventive visit include blood pressure, heart, body mass index, vision, medical history and wellness advice.

“It is important to note that when a patient has been enrolled in Medicare 366 days, they no longer can receive a Welcome to Medicare preventive visit, so it is important to schedule and go to the appointment within the first 365 days,” Lewis said.

People who have been enrolled in Medicare for more than 12 months are eligible for a free annual wellness visit.

Medical providers check on some of the same issues as the Welcome to Medicare visit, plus they  review current medications, and schedule recommended shots and screenings.

“Whereas the Welcome to Medicare preventive visit allows us to get to know our Medicare patients better, the yearly wellness visits allow us to monitor how our patients are doing and find out what needs they may have,” Lewis said.

The conversation between the medical provider and patient may include the patient’s diet, finances, means of transportation, amount of sun exposure and more.

The conversation enables doctors to better understand their patients and to provide for outside assistance when needed, Lewis said.

For information about preventive services that are free verses those that have co-pays, patients should check with their Medicare benefits coordinator or  medical provider’s billing department.