Medicare's New Wellness Benefit Sends a Powerful Message: Get Healthy!

Last Updated Feb 3, 2011 6:21 PM EST

Starting January 1, 2011, Medicare will pay the entire cost for an annual wellness visit for people who have enrolled in Medicare Part B. In addition, cost-sharing has been eliminated for virtually all preventative services. Now you've got no excuse not to make an appointment to get on the road to better health.

So what exactly should a wellness visit do? Quite simply, it should establish or update a personalized prevention plan that will help you determine exactly what you need to do to improve your health. Your wellness visit should start with a health risk assessment, which involves the following:
  • Establishing or updating your medical and family history
  • Creating a list of your current medical providers and prescriptions
  • Taking relevant health measurements, such as height, weight, and body mass index
  • Detecting cognitive impairments.
Your wellness visit should also establish a screening schedule for the next five to 10 years to detect common, serious medical conditions.

Your wellness visit may be conducted by a doctor, but that's certainly not a requirement. It can also be conducted by any health care practitioner whose services are recognized by Medicare, such as a nurse practitioner, a physician's assistant, a clinical social worker or psychologist, a health educator, a registered dietitian, or other professional working under the supervision of a physician. In fact, a health care practitioner who is not a physician may have more time to spend with you. Just be sure to that the health care practitioner you choose is recognized by Medicare.

The wellness visit builds on the current "Welcome to Medicare" checkup that's available free of charge to you within 12 months of becoming covered under Medicare Part B. Here's how the "Welcome to Medicare" and wellness benefits work together:
  • During your first 12 months of coverage, you're entitled to the free "Welcome to Medicare" checkup, but not the wellness visit.
  • After your first 12 months of coverage, you're entitled to the free wellness visit but not the "Welcome to Medicare" checkup.
What about if you're not yet 65, the eligibility age for Medicare? Don't wait to start your wellness program. Most modern medical insurance plans will cover preventative services without a copayment or deductible -- check your plan to be sure.

Unless you're Rip Van Winkle, you've probably heard that the cost of medical treatment has been skyrocketing for many years, with the potential to bankrupt Medicare. The win-win solution for Medicare is for all of us to get and stay healthy, so that we don't need to incur medical expenses. While the wellness visit can't guarantee that result for you, if everybody took advantage of this new benefit and followed the recommendations of their personal prevention plan, it would pretty much guarantee that Medicare would save a gazillion dollars and ensure that it would be viable well into our future. The new provisions described here are part of the sweeping Health Care Reform law that passed last year.

Follow your personal wellness plan, and you'll look and feel better now, reduce the odds of expensive and debilitating illnesses, most likely increase your lifespan, and potentially save you and Medicare a lot of money. So what are you waiting for?

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    Steve Vernon helped large employers design and manage their retirement programs for more than 35 years as a consulting actuary. Now he's a research scholar for the Stanford Center on Longevity, where he helps collect, direct and disseminate research that will improve the financial security of seniors. He's also president of Rest-of-Life Communications, delivers retirement planning workshops and authored Money for Life: Turn Your IRA and 401(k) Into a Lifetime Retirement Paycheck and Recession-Proof Your Retirement Years.

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