welcome to medicare visit eligibility

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Welcome to medicare preventive visit, preventive services.

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The Welcome to Medicare preventive visit is a one-time appointment you can choose to receive when you are new to Medicare. The aim of the visit is to promote general health and help prevent diseases.

Eligibility

Medicare Part B covers your one-time Welcome to Medicare preventive visit. Note that you must receive this visit within the first 12 months of your Part B enrollment .

Covered services

During the course of your Welcome to Medicare preventive visit, your provider should:

Check your height, weight, blood pressure, body mass index (BMI), and vision
Review your medical and social history
Review your potential for depression and other mental health conditions
Review your ability to function safely in the home and community
Provide you with education, counseling, and referrals related to your risk factors and other health needs
Give you a checklist and/or written plan with information about other preventive services you may need

The Welcome to Medicare preventive visit is not a head-to-toe physical. This visit is also separate from the Annual Wellness Visit (AWV) , which you can choose to receive once each year.

Original Medicare covers the Welcome to Medicare preventive visit at 100% of the Medicare-approved amount when you receive the service from a participating provider . This means you pay nothing (no deductible or coinsurance ). Medicare Advantage Plans are required to cover this visit without applying deductibles, copayments, or coinsurance when you see an in-network provider and meet Medicare’s eligibility requirements for the service.

During the course of your preventive visit, your provider may discover and need to investigate or treat a new or existing problem. This additional care is considered diagnostic, meaning your provider is treating you because of certain symptoms or risk factors. Medicare may bill you for any diagnostic care you receive during a preventive visit.

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Welcome to Medicare Preventive Visit

Written by: Bryan Strickland

Reviewed by: Malinda Cannon, Licensed Insurance Agent

Key Takeaways

You qualify for a “Welcome to Medicare” health assessment during the first 12 months you are enrolled in Part B Medicare Part B is the portion of Medicare that covers your medical expenses. Sometimes called "medical insurance," Part B helps pay for the Medicare-approved services you receive. of Original Medicare.

The visit, provided at no cost to you, sets a baseline for your health plan moving forward.

After the first year, the “Welcome to Medicare” results can be revisited at your annual wellness visit. Both are covered by Medicare but shouldn’t be confused with a “head-to-toe” annual physical, which is not covered.

Original Medicare Part B covers all the costs of one “Welcome to Medicare” preventive visit during the first 12 months you have Part B. This visit with a Medicare-approved doctor sets the baseline for your treatment moving forward.

You forfeit your opportunity for a “Welcome to Medicare” visit after 12 months on Part B, but you will then be eligible for a similar annual wellness visit once every 12 months at no cost to you.

When you call to schedule an appointment, you must make sure your doctor knows you’re specifically scheduling your “Welcome to Medicare” visit (or your annual wellness visit in subsequent years). It should not be confused with an annual physical, which Medicare does not cover.

Medicare Advantage plans, which replace Original Medicare and offer at least the same coverage as Parts A and B, also cover a “Welcome to Medicare” visit. Also, many Medicare Advantage plans cover other preventive services not covered by Original Medicare.

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What is Welcome to Medicare Preventive Visit?

The “Welcome to Medicare” preventive visit is not a comprehensive exam, but rather an assessment of your health by your doctor. At the end of your visit, your doctor will provide a plan for future care after establishing your health baseline. [i]

If treatment goes beyond what is covered by the “Welcome to Medicare” preventive visit, you may be financially responsible for additional services. You can receive treatment at the visit to avoid a return visit, but be sure you understand the potential financial impact.

What Happens at a Welcome to Medicare visit?

Your “Welcome to Medicare” preventive visit is an opportunity to assess your health and discuss ways to improve or maintain your health. After reviewing your medical and social history, you will receive helpful information from your doctor about your health and preventive services, including:

Covered annual screenings and vaccines, if needed, and referrals for other care.
Height, weight and blood pressure measurements.
A calculation of your body mass index.
A simple vision test.
Your risk for depression and your level of safety.
Discussion about creating advance directives.
A written plan letting you know which screenings, shots and other preventive services you need .

To get the most out of your appointment, you should plan ahead and be prepared. Have current prescriptions and your family history of significant health concerns ready for discussion. If you’re seeing a new doctor, this is essential information to include in your health plan.

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What is the Difference Between Welcome to Medicare and Annual Wellness Visit?

While the visits are similar, the “Welcome to Medicare” visit is only available during your first 12 months of Part B coverage and sets the baseline for health assessments going forward.

After your “Welcome to Medicare” preventive visit, annual wellness visits determine progress or decline in your health based on the health plan from your previous visit.

Both visits assess improvement or decline in your health and determine a care plan tailored to your needs of maintaining or improving your health. Medicare covers one “Welcome to Medicare” visit in the first 12 months you have Part B. After you have Part B for at least 12 months, Medicare covers one annual wellness visit each year. Your annual wellness visit may include a “Health Risk Assessment” similar to the “Welcome to Medicare” visit. [i]

Is the Welcome to Medicare Visit Mandatory?

A “Welcome to Medicare” visit is not necessary to maintain your Part B coverage, but it can be a valuable tool in your health journey and is offered at no cost in the first 12 months you are enrolled in Medicare Part B.

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“Welcome to Medicare” preventive visit TRUSTED & VERIFIED medicare.gov . medicare.gov.

Yearly “Wellness” visits . medicare.gov.

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