Medicare Annual Wellness Visit is Worthless

[harllee]

I had my so called "Medicare Annual Wellness Visit" today and in my opinion it was totally worthless. Medicare does not pay for an annual physical ( an annual physical at my doctor's office would cost me $300 plus out of pocket) so I decided to try the Medicare Annual Wellness Visit which is paid by Medicare. A total waste time. A nurse did my height and weight, took my blood pressure and temperature. Then I saw a medical social worker who asked me a few questions (for example she asked me if I had experienced anxiety over the last 2 weeks and I said yes --I was anxious about the coronavirus and she said she was too). She gave me 3 words to remember for a few minutes--I can still remember them 12 hours later--banana, chair, sunshine. In all took about 15 minutes--I never saw a doctor or a PA. Total waste of my time--I won't be doing that again.

I guess I will just wait until I feel sick and go to the doctor--Medicare does pay for 80% of that and my supplement pays the rest. Wouldn't it be better for Medicare to pay for an annual physical and keep us old geezers healthy? SMH

 

[MissMolly]

I had my so called "Medicare Annual Wellness Visit" today and in my opinion it was totally worthless. Medicare does not pay for an annual physical ( an annual physical at my doctor's office would cost me $300 plus out of pocket) so I decided to try the Medicare Annual Wellness Visit which is paid by Medicare. A total waste time. A nurse did my height and weight, took my blood pressure and temperature. Then I saw a medical social worker who asked me a few questions (for example she asked me if I had experienced anxiety over the last 2 weeks and I said yes --I was anxious about the coronavirus and she said she was too). She gave me 3 words to remember for a few minutes--I can still remember them 12 hours later--banana, chair, sunshine. In all took about 15 minutes--I never saw a doctor or a PA. Total waste of my time--I won't be doing that again.

I guess I will just wait until I feel sick and go to the doctor--Medicare does pay for 80% of that and my supplement pays the rest. Wouldn't it be better for Medicare to pay for an annual physical and keep us old geezers healthy? SMH

I 100% agree with the bold section. I have never understood why Medicare would not want to get out in front of many problems that would become evident at the time of a physical rather than waiting until the patient is sick.

 

[Teacher Terry]

I have heard this from others.

 

[travelover]

I agree. My doc spent the most time asking me questions to assess my mental capacity. Trouble is, my short term memory has always sucked.

 

[aja8888]

No blood test pull? That's what I get every Wellness Exam, plus spending time with my PCP. Looks like they only gave you 1/3 the exam.

 

[Another Reader]

I got a voicemail a couple of days ago from a staff person stating my doctor thought I might benefit from a Medicare Annual Wellness visit. First, I would have to be really, really sick to go anywhere near a large, multi specialty clinic right now, since there is absolutely zero benefit to me in catching the flu or the corona virus. Second, the real beneficiary of the visit is the bottom line of Palo Alto Medical Foundation and its' parent, Sutter Health, as these visits generate a lot of revenue for minimal consumption of staff time and facility resources. I have not returned the call.

 

[6miths]

The best available evidence indicates that annual health exams are not useful in reducing illness or prolonging life. Most recent review in the Cochrane Library is from a month ago. Here is another explanation from Harvard Medical.

 

[Katsmeow]

Wouldn't it be better for Medicare to pay for an annual physical and keep us old geezers healthy? SMH

Well, Medicare does pay for certain preventative tests just not an annual exam. Honestly, I think it is those tests that are more important than the physical itself.

 

[Teacher Terry]

My doctor wants me to get another colonoscopy. I will wait and see if I survive the Coronavirus first.

 

[Telly]

No blood test pull? That's what I get every Wellness Exam, plus spending time with my PCP. Looks like they only gave you 1/3 the exam.

Hmmm, that does not describe the actions of Medicare's AWV. Who is actually paying for your blood test?

This link is from CMS about AWV, it is targeted to providers. Has all the topics, and see the FAQs on page 13 wrt annual physical exam that some expect.

https://www.cms.gov/Outreach-and-Ed...MLNProducts/Downloads/AWV_Chart_ICN905706.pdf

And the Medicare.gov AWV page
https://www.medicare.gov/coverage/yearly-wellness-visits

 

[Bamaman]

The last two friends we had that smoked have not been getting annual physicals or chest x-rays. Both were stage IV lung cancer before they knew there was any problem. One lasted 4 months and the other 6 months.

Yearly physicals are important--including chest x-rays even if you have to pay out of pocket.

I'm type II diabetic and closely watched quarterly by a doctor. My doctor always does a blood chemistry analysis which tells the tale. Thankfully I'm very stable.

 

[harllee]

OP here, no blood test ordered. I had a blood panel last year and I was told I was not due for one for another 5 years!

 

[wmc1000]

No blood test pull? That's what I get every Wellness Exam, plus spending time with my PCP. Looks like they only gave you 1/3 the exam.

Yes, that is what we get also. Plus the doc does a cursory exam listens to heart, pushed on stomach, etc.

 

[harllee]

Yes, that is what we get also. Plus the doc does a cursory exam listens to heart, pushed on stomach, etc.

How does your doctor get Medicare to pay when they do all this? Last year my doctor did some extra things like the blood test and Medicare refused to pay. Maybe Medicare pays if you have some other health condition that warrants the blood test?

 

[braumeister]

How does your doctor get Medicare to pay when they do all this? Last year my doctor did some extra things like the blood test and Medicare refused to pay. Maybe Medicare pays if you have some other health condition that warrants the blood test?

I've never had less than a full exam, including blood work.
A couple of glitches when I first went on Medicare, but in general I think it boils down to the idea that some doctors know how to best code things for payment and others don't. No evidence to support that, just my impression.

 

[friar1610]

I've never had less than a full exam, including blood work.
A couple of glitches when I first went on Medicare, but in generalI think it boils down to the idea that some doctors know how to best code things for payment and others don't. No evidence to support that, just my impression.

I agree. My doc apparently codes things in a way that ties the blood work to a previous condition he's been following. I've had fairly high cholesterol so I always get the lipid panel. I've had prostate cancer so I always get the PSA. There are other tests as well that I never seem to get charged for.

 

[harllee]

I agree. My doc apparently codes things in a way that ties the blood work to a previous condition he's been following. I've had fairly high cholesterol so I always get the lipid panel. I've had prostate cancer so I always get the PSA. There are other tests as well that I never seem to get charged for.

OP here--that is probably my problem--I am too healthy, no present medical conditions, prior labs good, I take no medications so I guess my doctor does not have any way to tie the blood work to a medical condition so that Medicare will pay it.

 

[misanman]

I guess I will just wait until I feel sick and go to the doctor--Medicare does pay for 80% of that and my supplement pays the rest. Wouldn't it be better for Medicare to pay for an annual physical and keep us old geezers healthy?

I agree. Last time I had a wellness visit the doctor more or less said "Why would I order a blood test? It's always the same and your general physical condition hasn't changed." Seemed shortsighted and there is no reason to go back until I'm sick.

 

[wmc1000]

How does your doctor get Medicare to pay when they do all this? Last year my doctor did some extra things like the blood test and Medicare refused to pay. Maybe Medicare pays if you have some other health condition that warrants the blood test?

As others have stated it is probably in the coding. As I do take Rx's for cholesterol and BP although I took 1 of those 5 test package deals and everything was reported as normal/within range.

 

[RonBoyd]

I don't understand. I am on a Medicare Advantage plan so that may explain some of it. I have never been charged more than a co-pay -- which this year is $0. I do have to sign a release that says something like "if during the examination an issue is found that needs medical care, it will be treated as a separate visit." Not only does the AWV include a thorough examination by the doctor, including blood work, but United Healthcare gives me a $10 "reward" for having it done.

I can't imagine a $300 charge for that... is this a "deductible" charge?

Full disclosure: (I have Atrial Fibrillation and on Warfarin) I have elected to have my Prothombine Time (INR - International Normalized Ratio) performed by my PCP. This is done every 2 months. The test takes about a minute and gives us about fourteen minutes for chit chat. Therefore, my "annual" physical is more of a formality than normal so that may bias my opinion.

 

[harllee]

Op here I have traditional Medicare and a supplement so a regular physical is not covered at all. All I get is the annual wellness exam which for me is worthless

 

[beowulf]

Last summer our primary care physician urged us to get the "free" annual Medicare wellness exam. As mentioned by others, it was a total waste of time. We were seen by someone who was not a RN or LPN. Maybe a social worker? Whatever she was, I would have been better off seeing my Dr for a RX renewal visit, which consists of a general exam - blood pressure, listening to heart and lungs, checking all vitals and a slew of lab tests. According to my Medicare records, he charged $478 and received $196 for a G0438 - Annual Wellness Visit; Includes A Personalized Prevention Plan Of Service (Pps), Initial Visit plus another $239 of which he received $96 for a code 99497 - Advance Care Planning By The Physician Or Other Qualified Health Care Professional. This took all of 20 minutes, no tests, no anything and the person doing it tried to sell me some online subscription to a service that would keep track of all my medical records and make recommendations for me to follow up with my Dr. This whole thing is a scam. I brought it up with my Dr the next time i saw him and he was embarrassed - he said the practice (which was bought by some sort of holding company last year) required him to ask that we take the Wellness exam. Clearly a revenue enhancer that should be stopped. I guess some folks would never go to a Dr without this, but it's really wasted tax money.

 

[athena53]

I agree on the wellness visit and have also been burnt by bad coding. Now I order my own bloodwork through requestatest.com. I'm also getting a new PCP because the staff of the old one couldn't code properly and ignored requests to re-code. I'm trying to manage cholesterol levels and a1C through diet and exercise so I do want to monitor those regularly.

The wellness visit might POSSIBLY screen for a few things- overweight, high BP, depression, early dementia- but it doesn't seem very useful. I haven't had one in the 2 years I've been on Medicare. I know my weight and BP and the rest are not concerns.

 

[OldShooter]

I don't have most of these issues; I get good physicals with blood work annually and Medicare seems to pay. I do, however, make it clear to my Dr. that I will private pay as necessary. IOW he should not consider cost to be a concern.

Why did we save all this money if we aren't willing to use it to ensure our own health?

 

[Amethyst]

This is interesting. Haven't aged into Medicare yet, am still on BCBS Basic (now Florida Blue). They pay for one well-person physical per year, which always seemed to cover anything my Dr. had any concerns about, including lipid panels and an EKG, since I have elevated Cholesterol and a family history of cardiac disease. Oh, and a bone density test every 2 years, since I have osteopenia. If Medicare doesn't pay for lipid panels and other rather standard screenings, which I currently receive, then why should I even go on Medicare?