Are annual physicals a must?

[braumeister]

Quote:

Originally Posted by Marita40 I would like to know, too, whether Medicare covers annual bloodwork. Given the "lite" Wellness exam, I doubt it. I like blood work. "Blood don't lie."

Mine has always been covered, but I have seen it paid sometimes by Medicare and sometimes by my supplement. I have also seen that whether something is paid by Medicare or not depends on how it's coded when the claim is sent in. Some docs (or their billing persons) are more savvy than others in this regard.

[REWahoo]

Quote:

Originally Posted by braumeister I have also seen that whether something is paid by Medicare or not depends on how it's coded when the claim is sent in. Some docs (or their billing persons) are more savvy than others in this regard.

+1

Earlier today I scheduled a physical for next month, my first since going on Medicare 10 years ago (this thread spurred me to action). The nurse practitioner who will do it, a friend and former neighbor, said Medicare would pay for "almost everything".

[Keim]

One of my closest friends was diagnosed with colon cancer in June at 49. He was in generally good health until he wasn't. Then he died.

[kgtest]

Quote:

Originally Posted by Keim One of my closest friends was diagnosed with colon cancer in June at 49. He was in generally good health until he wasn't. Then he died.

My condolences. My sister passed from this same wretched disease 2 months ago. She was popping off about 3 months ago, the last month went downhill quick. She battled for 3 yrs but that last month went from seemingly good to dead quickly. You can't pick your time.

[bluelight]

My husband regularly sees a rheumatologist and a pulmonologist due to some medical issues he has. He thought that was enough as he was seeing them twice a year.

A few years ago he ended up with a sinus infection that warranted a doctor visit. The GP talked him into setting up an appointment for a physical, which he had not had in at least 5 years. While he had been getting his blood tested for the specific illness as required by his specialists, his PSA had never been part of those tests. The level was high and he was diagnosed with prostate cancer. Luckily he was in stage one and the cancer was treatable with radiation.

[Peter]

My doctor is a bit of a 'by the book' guy and insists that the Medicare wellness exam doesn't include annual blood work. But I hear of many on this board, and elsewhere, that do have it covered. I suspect it's a question of how far your individual doctor wants to push the boundaries.

[Ronstar]

I wouldn't say that they are a "must". But annual exams to include blood work can help detect problems before they become serious.

I went for the medicare wellness exam in 2020 and 2021. Last physical exam before that was 2004. The 2020 exam provided my doctor with baseline info to compare future exam results to. There were some issues in my 2020 exam, but there was no previous data for my doctor to compare my results to. So I think it's important to get checked often to build a database of health info.

[FLSUnFIRE]

At 40 I started going to establish a history and a baseline so when things go wrong, we know what my normal is. I was also diagnosed with a minor condition then (asymptomatic but long term could lead to symptoms later in life if not treated... $40/yr prescription so cheap insurance). I like my Dr, he is younger than me and hopefully not going to FIRE so I can stick with him for a long time.



My brother had scary adverse reaction to the COVID vaccine but never went to the doc before so trying to figure out if he is back to normal is more challenging for him and his doctors. I still don't think he has a primary but he's got a hematologist now!

[Car-Guy]

Quote:

Originally Posted by DayVee B I just think if nothing is wrong, why go. No family history of cancers or major other issues So, are annual physicals really necessary?

You need to talk a neighbor of mine.... Very similar family history and line of thinking.... He got away with it until his late 60's...

[RetiredHappy]

Medicare covers blood work, no limit. My husband gets routine blood work and urine test twice a year (5 tubes of blood each time), and ad hoc blood work when requested by his other doctors.

[braumeister]

Quote:

Originally Posted by DayVee B I just think if nothing is wrong, why go.

Yes, that's exactly the point. Without getting periodic lab reports, you have no idea whether something might be wrong or not. Noticeable symptoms are often the last thing to occur.

[fh2000]

I started to see my primary physician 20 years ago annually.

In my 40's, he showed me my cholesterol level: 240. I started to exercise and control my diet.
In my 50's, he showed me my stool test result. I started to do colonoscopy. I have done 3 times since.
In my early 60's, he showed me my Xray, and gave me a referral. I went for a lung surgery and removed a tumor.

To me, annual physical is a must even if you are young. Any of those could have killed me already.

[SecondCor521]

I've been getting annual physicals with blood work for the past five years or so. I also am up on all my shots and preventative screenings.

My logic is that women live longer on average than men, and IMHO part of the reason for that is that women tend to see their doctors more regularly (for mammograms, Pap smears, etc.). I wanted to live longer on average, so I decided to emulate women in that regard. So I get an annual physical.

Results over that time frame?

My colonoscopy found and removed an adenoma. I'm glad they remove things that are precancerous and asymptomatic rather than when they become colon cancer. Will happily go back when I'm 55.

I had an anomalous PSA reading once. Figured it out, got it fixed. Glad it wasn't prostate cancer, which can be asymptomatic until it gets far enough along or fast enough to kill you early.

I haven't had COVID or the flu.

This year my blood work was finally all normal. I have had some mildly off cholesterol readings, which spurred me to exercise, which helped get the numbers back in line.

Better to nip things in the bud, in my opinion. There are a number of things that can kill you at this stage in life, that you can feel fine with for a while, that are more treatable if caught early.

It's also nice to be reassured periodically that my heart, lungs, liver, kidneys, prostate, etc. are working fine for now.

To reiterate what I said at the start - I think people can skip their annual physicals if they want to, but on average those people will probably have poorer health and will die earlier than those that go.

There can be false positives that may be a bit of a hassle to follow up on - like my PSA reading, for example - but even considering that I think they're worth it.

[harllee]

At age 70 I want to get an annual physical and blood work every year but I have to fight Medicare to get them paid and I sometimes end up paying for them out of pocket.

[RetiredHappy]

Quote:

Originally Posted by harllee At age 70 I want to get an annual physical and blood work every year but I have to fight Medicare to get them paid and I sometimes end up paying for them out of pocket.

What sort of Medicare plan are you on?

[harllee]

Quote:

Originally Posted by RetiredHappy What sort of Medicare plan are you on?

Traditional Medicare and G Supplement through United Health Care. Traditional Medicare will only pay for the annual wellness visit which is worthless--not a real physical at all. For blood work, Medicare eventually paid but I had to jump through hoops to get doctor to resubmit with a different code because Medicare said I should not get annual cholesterol blood work paid since I had no health problems. Ironically it seems Medicare does not want to pay if you are too healthy (even though I am age 70).

[braumeister]

Quote:

Originally Posted by harllee I had to jump through hoops to get doctor to resubmit with a different code

Yes, that was the point I made earlier. Some docs are more savvy than others, so they know how to code things to get paid quicker.

[Car-Guy]

Quote:

Originally Posted by harllee At age 70 I want to get an annual physical and blood work every year but I have to fight Medicare to get them paid and I sometimes end up paying for them out of pocket.

Really, 70+ too and my annual blood work cost is zero, no problems, ever. Even when I needed extra blood work done in the same year, it's been covered at 100%

[RetiredHappy]

Quote:

Originally Posted by harllee Traditional Medicare and G Supplement through United Health Care. Traditional Medicare will only pay for the annual wellness visit which is worthless--not a real physical at all. For blood work, Medicare eventually paid but I had to jump through hoops to get doctor to resubmit with a different code because Medicare said I should not get annual cholesterol blood work paid since I had no health problems. Ironically it seems Medicare does not want to pay if you are too healthy (even though I am age 70).

So it would appear that it's doctor's office / lab coding issue. We use a lab called Quest Diagnostics and have not had any issues getting any / all tests covered.

[schellem]

The book 'Calculated Risks: How to Know When Numbers Deceive You' has really enlightened me on many things discussed in this thread. Shows just how poor doctors are with statistics and explaining things to their clients and how big pharma drives a lot of 'fear' in relation to health testing.

I won't be following the many 'standard' recommendations that the industry now recommends after reading this book.