One-time-only Welcome to Medicare visit mandatory? My insurance co says it is.

[John Galt III]

I am new to Medicare, and am scheduling my yearly physical. I called up my insurance co, Capital Blue Cross, to make sure what was covered, and what was the minimum I needed to do. The rep said the 'Welcome to Medicare' thing with all the forms and revealing parents' and siblings' health issues, was mandatory, and that I could be penalized and possibly kicked off Medicare if I did not have the 'Welcome to Medicare' visit done, which sounds pretty bizarre. What incentive would Cap Blue Cross have for me to get the 'Welcome to Medicare' stuff done? More medical info about me and my family members, and reasons to deny coverage? I looked online and one website said no, it is NOT mandatory. I sort of want to give them the least information I can. I made an appointment with my doctor for a welcome to medicare visit, but am thinking of calling him back and changing it to just a plain old minimal 'wellness visit'. Any input appreciated!!

 

[audreyh1]

Kicked off Medicare? Why do I not believe that.

 

[braumeister]

I made an appointment with my doctor for a welcome to medicare visit, but am thinking of calling him back and changing it to just a plain old minimal 'wellness visit'. Any input appreciated!!

I can assure you that the "Welcome to Medicare" wellness visit is indeed minimal.

And nothing about it is mandatory, so you can relax.

 

[REWahoo]

The rep said the 'Welcome to Medicare' thing with all the forms and revealing parents' and siblings' health issues, was mandatory, and that I could be penalized and possibly kicked off Medicare if I did not have the 'Welcome to Medicare' visit done...

Balderdash and poppycock, not to mention hooey.

 

[MichaelB]

Balderdash and poppycock, not to mention hooey.

And codswallop

 

[Spock]

"Capital Blue Cross"
sounds like Medicare Advantage and not Medicare?

 

[John Galt III]

"Capital Blue Cross"
sounds like Medicare Advantage and not Medicare?

Yes, it's a Medicare Advantage HMO. Now that I think back on the conversation, the rep said Medicare might increase my monthly premium if I did not complete the 'Welcome to Medicare' visit. More codswallop, perhaps. But why would the rep say this?

 

[braumeister]

Yes, it's a Medicare Advantage HMO.

In that case, disregard my post above. I know nothing about those plans.

 

[Gotadimple]

Welcome to Medicare meeting - it's not a physical - is generally required for the first year you are in Medicare and in a Med Advantage plan. Your gov't is requiring them to talk to you about your health and remind you about power of attorney for medical care.

Go. Listen politely and don't provide any info to your doctor you don't want to. Your info is NOT passed on to Medicare, it is a part of your health record. Medicare only cares about info that supports a claim. Your doctor will report you had a visit, and he/she will get paid for the Welcome Visit. Done. On to other things.

 

[Sunset]

Welcome to Medicare meeting - it's not a physical - is generally required for the first year you are in Medicare and in a Med Advantage plan. Your gov't is requiring them to talk to you about your health and remind you about power of attorney for medical care.

Go. Listen politely and don't provide any info to your doctor you don't want to. Your info is NOT passed on to Medicare, it is a part of your health record. Medicare only cares about info that supports a claim. Your doctor will report you had a visit, and he/she will get paid for the Welcome Visit. Done. On to other things.

Wow.... what a waste of Medicare $$$.
After all it's not like OP has never been going to a doctor, like most folks, OP will probably go to the SAME doctor as previous years.... so a total waste of $$.

 

[ShokWaveRider]

Wow.... what a waste of Medicare $$$.

That is exactly what my doctor said, as I result I did not bother to do it. I am not senile, not yet at least, and can well afford to support myself.

Now for 48% of the population, regardless of being at Medicare age or not, it may be a good thing.

 

[John Galt III]

Welcome to Medicare meeting - it's not a physical - is generally required for the first year you are in Medicare and in a Med Advantage plan. Your gov't is requiring them to talk to you about your health and remind you about power of attorney for medical care.

Go. Listen politely and don't provide any info to your doctor you don't want to. Your info is NOT passed on to Medicare, it is a part of your health record. Medicare only cares about info that supports a claim. Your doctor will report you had a visit, and he/she will get paid for the Welcome Visit. Done. On to other things.

Thanks, Gotadimple.

Another interesting bit I just found out, after digging around in the medicare.gov website, is that if I try to have a regular wellness visit instead of the welcome to medicare visit, then the wellness visit, if done during the first 12 months of being in medicare, will NOT be covered. But... a welcome to medicare visit will be covered (and only in the first 12 months), although it is not mandatory to have one.

Cut to chase. Since my primary care doctor insists I appear once per year (for any reason) in order to write my prescriptions, I will tell the doc office to code it as a welcome to medicare visit, so it will be covered, and I can get prescriptions renewed as usual. I will tell them the same info I have already told them before.

The Cap Blue Cross rep said that both the a wellness visit AND a welcome to medicare visit would be covered 100% if the doc chose to bill both of them. Obviously she was wrong, along with the penalty hogwash.... Discouraging that the reps are so poorly trained.

Caveat emptor as usual, lol.

 

[Katsmeow]

DH is on regular Medicare not Medicare Advantage. Anyway, at our old doctor's office (before we moved) that doctor required him to come in for the annual wellness visit or he would be dropped by the doctor. Apparently there was some advantage to the doctor (financial?) with them having patients do the wellness visit so the doctor made it mandatory for patients to do it or they would have to find a different doctor.

 

[ShokWaveRider]

And your Chicks for free.....

 

[CRLLS]

Now I'm starting to get worried. I never went for my "Welcome to Medicare" visit. That was over 2 years ago. I haven't been to my annual wellness visit either. Fact is, I don't have a Dr. Medicare still accepts (takes) my premiums and I have not been sent any letter saying I would be thrown out of Medicare. I know I need to find a GP, I wonder if my reluctance to going earlier will affect that.

 

[Telly]

Now I'm starting to get worried. I never went for my "Welcome to Medicare" visit. That was over 2 years ago. I haven't been to my annual wellness visit either. Fact is, I don't have a Dr. Medicare still accepts (takes) my premiums and I have not been sent any letter saying I would be thrown out of Medicare. I know I need to find a GP, I wonder if my reluctance to going earlier will affect that.

Don't worry. Be happy.
There is no requirement in Medicare that you HAVE to attend any wellness visit, nor that you have to have a PCP.

Pre-Medicare, I had a PCP that I very infrequently visited, usually years between visits. When I was ~64 1/2, the practice sent me a letter that said they would not accept any Medicare patients except from those who were covered by one of four specific MAs that they listed. No Part B'ers, go away. Really odd, but then they were bought up by an aggregator outfit that puts multi-location practices into a bigger group.

For a person that has gone the MA route instead, they probably have to have a PCP, one in their MA plan, who acts as gate keeper or NO man.

I have not done anything solid about finding a replacement PCP. I'll get to it sometime. If something comes up quick, I can go to an urgent care place that takes Medicare assignment.