Medicare Part B (Medical Insurance) covers a “Welcome to Medicare” preventive visit once within the first 12 months you have Part B.
Your costs in Original Medicare
You pay nothing for the “Welcome to Medicare” preventive visit if your doctor or other qualified health care provider accepts assignment. The Part B deductible doesn’t apply.
However, you may have to pay coinsurance, and the Part B deductible may apply if your doctor or other health care provider performs additional tests or services during the same visit that Medicare doesn't cover under this preventive benefit. If Medicare doesn't cover the additional tests or services (like a routine physical exam), you may have to pay the full amount.
Your doctor or other health care provider may recommend you get services more often than Medicare covers. Or, they may recommend services that Medicare doesn’t cover. If this happens, you may have to pay some or all of the costs. Ask questions so you understand why your doctor is recommending certain services and if, or how much, Medicare will pay for them.
What it is
During this visit, your doctor or other health care provider will:
- Review your medical and social history related to your health.
- Give you information about preventive services, including certain screenings, shots or vaccines (like flu, pneumococcal, and other recommended immunizations).
- Take height, weight, and blood pressure measurements.
- Give you referrals for other care as needed.
- Calculate your body mass index (BMI).
- Give you a simple vision test.
- Review your potential risk for depression.
- Offer to talk with you about creating advance directives.
- A written plan (like a checklist) letting you know what screenings, shots, and other preventive services you need. Get details about coverage for screenings, shots, and other preventive services.
Things to know
When you make your appointment, let your doctor’s office know you would like to schedule your “Welcome to Medicare” preventive visit. Bring the following to your appointment:
- Medical records, including immunization records.
- Family health history.
- A list of any prescription drugs, over-the-counter drugs, vitamins, and supplements that you currently take, how often you take them, and why.
If you have a current prescription for opioids, your provider will review your potential risk factors for opioid use disorder, evaluate your severity of pain and current treatment plan, provide information on non-opioid treatment options, and may refer you to a specialist, if appropriate. Your provider will also review your potential risk factors for substance use disorder, like alcohol and tobacco use, and refer you for treatment, if needed.