When Dr. Regan Chan’s older patients are about to turn 65 and qualify for Medicare, they can be full of doubts or questions. Not just questions about their health; they might be confused about their new insurance, including the wellness visits that are offered free.
“Many still don’t know about these visits. ‘Is it a checkup?’ they often ask,” says Chan, a primary care physician at UCI Health Medical Group in Orange.
The “Welcome to Medicare” doctor visit has been around for 10 years, Chan says, and in 2011, the Affordable Care Act made it an annual benefit. The complete cost is covered by Medicare, with no copayment — but it’s not a physical exam. Instead, patients sit down with their doctor to talk about their health and work together to create a plan of care to keep them healthy.
The confusion is understandable, especially because early versions of the government’s official Medicare handbook described these as “physical exams” and “wellness exams.” To most people, an exam means a hands-on examination, but Medicare doesn’t cover routine physicals, Chan says. The wording has been changed; the newest version of the “Medicare & You” brochure calls it a “preventive visit” and provides a clearer description of what that entails.
Questions about coverage
The annual visits are just one of many aspects of Medicare that tend to confuse people. They want to know:
- When do I have to sign up? And how?
- Why is there a Part A and a Part B?
- Do I need supplemental insurance?
- What about all these brochures about Medicare that I’m getting in the mail from private insurers?
What will you chat about?
Chan finds the wellness visits valuable even though there is no head-to-toe physical exam — or maybe because of it. After all, when was the last time a doctor sat down with you just to listen to you and discuss your general well-being? Or to plot out with you a concrete, written and personalized plan for improving or maintaining your health for the next five to 10 years?
When people visit the doctor for a physical ailment, they’re thinking about fixing that one problem, not the bigger health picture.
“Now, you can put the other things aside for a moment,” Chan says. “You’re able to just focus on health issues that matter to seniors. What can we do to keep you healthy? Among other things, we talk about your diet and your exercise, appropriate cancer screenings, vaccinations you might need, your advanced directives, and more.”
Chan says UCI Health primary care doctors have patients fill out a detailed health questionnaire beforehand. Then doctor and patient review the information in depth. An EKG may be included, if indicated. And if potential problems are identified — the doctor can make referrals or recommendations for other wellness services that would be covered by Medicare.
Patients with chronic or pre-existing conditions will receive tests and follow-up care as necessary.
How to prepare for your visit
In addition to completing the questionnaire, patients can prepare for their preventive visits by creating a list of all medications they take, including doses — or just drop their medication bottles in a bag and bring them along. This is a good time to look for medications that might interact badly, Chan says.
Patients also should pull together their available medical records, including the names of other doctors they might have seen over the years, or from recent hospital stays. And they should think about any concerns they have that they might never have mentioned to others.
“In these visits, patients sometimes bring up things that might be sensitive to them — urinary incontinence, fears of becoming less independent, depression or memory problems, for example.
“It really is a great tool to help identify conditions that can affect our senior patients,” Chan says. “More importantly, it gives me an opportunity to create a personalized checklist that we can review year after year to make sure we’re keeping you on track toward the best of health.”