Has Anyone Done An Annual "Wellness " Visit

StarSong said:
I still get an annual physical from my doctor. He listens to my heart and lungs, arranges for an assortment of blood tests, checks my breasts, palpates my abdomen and neck, asks about my general health, and orders other tests based on my concerns. I haven't had a urinalysis since a raging UTI about 15 years ago.

He doesn't do a routine EKG, but with my having no history of heart problems I'm not sure I need one. (I had several this summer because of rampant PVCs that have settled down, thank goodness.)

What did the new doctor do during your "wellness visit?"
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He didn’t touch me. I asked him if he was going to listen to my heart and lungs and he said that the Federal government doesn’t allow them to do that! He asked me a bunch of questions about end of life directives and then sent me to the lab for bloodwork.
A woman who I guess was a nurse? …Who knows as she didn’t introduce herself, took my blood pressure and weighed me before I saw the doctor. I found the whole thing very weird.
I have Aetna Medicare Advantage health insurance through my husband’s employer.
 

I do it every year. I need my thyroid checked because of hyperthyroidism. Oddly, it’s now back in the normal range. I do not take any medication for it. She runs most of the other basic tests too - A1C, glucose, cholesterol, etc. And the cognitive test of course. I’m still in the green on everything. I make health a priority. I have a younger sibling who has all the usual problems - diabetes, heart disease, cholesterol, overweight. I don’t want to go that route. He takes many pills.

I have regular Medicare, Plan G. I pay the premium and annual Medicare deductible and they take care of the rest - including the PITA paperwork.
 

No annual welless visits for me anymore. I've posted about this a couple of months ago. It must have been a thread similar to this one, but different.

Everyone said "get your annual wellness visit" + "Medicare requires it" - etc., and blah blah blah. By the way, Medicare does NOT require it, even though many people are under that impression. So I did get one, then my advantage plan denied payment - without giving a reason. It appears it was denied because I saw the doctor for blood work and a check up on or about the same time, and the insurance didn't feel both were necessary. [But I'm not sure if that's the reason, since they didn't explain.]

I phoned the clinic and told them I will not get anymore "wellness" visits. Nothing happened, then, a few days ago, the clinic office called and told me they wrote off the $260.00 that was denied, but I "shouldn't have to worry about it." It's not that I'm worried about it, but It's a small rural clinic and I don't feel it's fair they should have to write it off, nor can I see any need for a wellness visit, which is classified separately from a regular visit, when the regular visit and blood work accomplish the same thing.

[The Medicare Annual Wellness visit" is not to be confused with regular blood work and doctor visits every 6 months.] They are separate things, and they are billed separately, even if both are scheduled simultaneously, which is how it was in my case.]
 
MaidMarian said:
He didn’t touch me. I asked him if he was going to listen to my heart and lungs and he said that the Federal government doesn’t allow them to do that! He asked me a bunch of questions about end of life directives and then sent me to the lab for bloodwork.
A woman who I guess was a nurse? …Who knows as she didn’t introduce herself, took my blood pressure and weighed me before I saw the doctor. I found the whole thing very weird.
I have Aetna Medicare Advantage health insurance through my husband’s employer.
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Unfortunately, a wellness exam is not really a physical. They just ask you a bunch of questions basically and bill Medicare a lot of money. It is a real Cash cow for doctors and hospitals but of little benefit to the patient. Although I refuse to do the wellness exam, I do go to my doctor yearly for a regular examination and to do my blood work.
 
SeaBreeze said:
I only see the doctor every several years when I'm ready to get a blood check. I have Medicare Advantage through Kaiser Permanente and Kaiser sent me a Medicare questionnaire to voluntarily fill out online. I answered all the questions although there was always a choice not to answer each question. None were very invasive, all very general.
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I love those questionnaires.

I am reasonably certain the poor bastard actuaries sifting through the responses do not love me back.

Luce,
Professional statistical outlier.
 
My crappy insurance company keeps reminding me to get a "wellness visit".

Not happening. I only go when I feel like something isn't right that I haven't a clue about. And then the doctors don't really listen and try to suggest a prescription drug for something completely unrelated.

Like I said, not happening.
 
Teacher Terry said:
Unfortunately, a wellness exam is not really a physical. They just ask you a bunch of questions basically and bill Medicare a lot of money. It is a real Cash cow for doctors and hospitals but of little benefit to the patient. Although I refuse to do the wellness exam, I do go to my doctor yearly for a regular examination and to do my blood work.
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I just had a wellness exam in June.
Medicare didn’t/doesn’t pay near what they’re billed for the visit.
At this same visit my regular 6-month lab work was reviewed & i also had the opportunity to ask questions.
Medicare paid a total of $141.46 for this wellness visit.
I thought it was worthwhile & didn’t think the payment was out of line.
I dunno, maybe some doctors bill for additional types of screenings?
(My doc must have asked if i ever have a drink, see Annual Alcohol Misuse Screening shown below.)

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MaidMarian said:
He didn’t touch me. I asked him if he was going to listen to my heart and lungs and he said that the Federal government doesn’t allow them to do that! He asked me a bunch of questions about end of life directives and then sent me to the lab for bloodwork.
A woman who I guess was a nurse? …Who knows as she didn’t introduce herself, took my blood pressure and weighed me before I saw the doctor. I found the whole thing very weird.
I have Aetna Medicare Advantage health insurance through my husband’s employer.
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If it were me in your shoes, I'd be looking for a different doctor at a different medical practice. Immediately, if not sooner.
 
I'm on an Advantage plan (Kaiser Permanente) and don't know if they classify my annual checkups as wellness exams, physicals, or something else. Rarely any co-pays, and they've provided pretty good care, though sometimes I have to rattle a few cages to get it.

People need to be their own healthcare advocates, which has always been true. Only difference is that doctors can no longer keep our health records to themselves.

Surely every woman on this forum had similar experiences to mine back in the day: "I'm curious, what's my BP?"
"Don't you worry about that, honey. You focus on finding yourself a nice husband and let me worry about your BP." If he'd included a pat on the head and a lollipop from the treat jar, the feeling of being treated a five year old would have been complete.
 
Lizzie00 said:
I just had a wellness exam in June.
Medicare didn’t/doesn’t pay near what they’re billed for the visit.
At this same visit my regular 6-month lab work was reviewed & i also had the opportunity to ask questions.
Medicare paid a total of $141.46 for this wellness visit.
I thought it was worthwhile & didn’t think the payment was out of line.
I dunno, maybe some doctors bill for additional types of screenings?
(My doc must have asked if i ever have a drink, see Annual Alcohol Misuse Screening shown below.)

View attachment 447177
View attachment 447178
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UPDATE:
I just took another look at my 6/2025 EOMBs.

It seems MACKTEXAS is absolutely correct (Post #79) when he says, “The Medicare Annual Wellness visit is not to be confused with regular blood work and doctor visits every 6 months. They are separate things, and they are billed separately, even if both are scheduled simultaneously, which is how it was in my case.”

Further review of my own EOMBs reflect that Medicare DID pay for both my wellness visit AND also for a simultaneous regular 6-month visit. But I’ve got regular Medicare (versus an advantage plan) so i can only guess that therein lies the difference.
 
My health insurance company bugs the hell out of me to get a "Wellness Check". They want to send a nurse to do the check. When I tell them I'm a retired R.N., it doesn't seem to sink in. All I know is the insurance company is hot and bothered to do a "Wellness Check" on me, that I don't need. Somehow, somebody is making lots of cash for this.
 
well, there in lays the problem for all of us. The "wellness" visit is at least contact with someone and information that is documented. It is not the way it use to be when you went to your family doctor. Those days are gone. You need to be your own quasi physician these days. You made an appointment, they wrote down the results. They looked at your history and make recommandations. Today they do pretty much the same except they don't know you nor does it matter to them.
If you feel that something else is going on you need to express it. Remember, they don't know you. So speak up about concerns. Speak up about your conditions. Sorry, but to be cold. The old days are gone. Bemoan them all you want but they are not coming back. No one has your back but you and those who love you. Sometimes we know things are wrong but we go into denial. WE don't want to face what we think.
In the old days your family physician would catch you and give you information that you don't want to hear. But you knew them, they knew you so they got you thru the denial.
Today you can deny till the day you die. No one is going to disagree because they don't know you. Think about it all. The world is different. I don't care for it. You don't either but you need to deal with it.
 
Actually I have had the same family doctor for 28 years ever since I moved here. She is only four years younger than me and intends to retire when she hits 70 and I will really miss her.

She knows me very well and if you have a lot of problems, she spends longer than 15 minutes with you. I always book early morning appointments, because she can easily be behind a couple hours by the afternoon. She really cares about her patients.
 
I was placed on the high risk list with my PCP. I have regular nurse visits where they come and take my vitals. they track my health issues. they try to keep me out of the hospital. It doesn't always work.
 
The first I heard of a wellness visit was a few years ago. I go in once a year to have blood pressure prescriptions renewed. The drs office called me to schedule my "annual wellness visit". I thought it was for the normal annual visit. Got it scheduled and when I arrived, I had to complete about six pages of questions, lots of psych questions, social patterns/habits (alcohol, marijuana, etc.), how many people live in the home, abuse questions. Most of the questions were very personal and had nothing whatsoever to do with my physical health.

I drew a large X across the pages and signed them. Was called into the exam room and a woman came in, looked over the forms, asked a few questions and that was it. I asked if they were going to review meds and renew scripts. No. This was a wellness visit. What's that? When I learned, I was angry because it is a long drive and nothing was done. Had to make a second appointment several months away, which meant my scripts would run out before then. After angrily telling them that now my scripts would run out, they agreed to phone them into the pharmacy before that second appointment.

Last year, the wellness visit was combined with the regular annual exam. It was billed that way through Medicare. Two birds with one stone insofar as they were concerned. It's a ripoff!

In addition to THAT ripoff, there is the annual "low-dose preventive chest x-ray", fully covered by Medicare. I refuse it every year. Tricky business they have become in that just last week, I received a card from them that actually looked like they had made an appointment for that x-ray. It took close reading to realize it was a "suggested" appointment! I threw it in the trash. They always ask about a colonoscopy, too. No. The more they ask for, the less I agree to. I am at the point that I will only go when I think something is seriously wrong and for the annual visit to get my scripts renewed, unless I can figure out a way to get them without going.

One thing that I do is ask them to renew the scripts to be filled for a year. I pay cash for them, not insured. The local pharmacy's prices are ridiculously low. I get four scripts, filled for a year, for $180. I have taken these same blood pressure meds for years without change. Why go through the PITA of refilling them monthly or every three months. AND now I schedule that annual exam a month early. Over a few years, it has allowed me to accumulate a few extra months of meds. Just my way of working the system.
 
Goodenuff, on one visit the medical assistant cheerfully announced She was combining that appointment with a wellness visit and I told her absolutely not and then I will never do a wellness visit. I told her to never mention it again and she hasn’t.
 
It was a waste of my time.

Medicare could save millions by axing the Annual Wellness Visit. I told my doctor back then I won’t be doing another one. That was 6 years ago. I think he asked me a few questions and said ok, thanks for coming in. I saw the charge to Medicare was $180 and Medicare paid $160. My supplemental paid $5 because Medicare approved $165. My wife went though the same ordeal and told our doctor the same thing. No more Wellness Checks.
 
MaidMarian said:
He didn’t touch me. I asked him if he was going to listen to my heart and lungs and he said that the Federal government doesn’t allow them to do that! He asked me a bunch of questions about end of life directives and then sent me to the lab for bloodwork.
A woman who I guess was a nurse? …Who knows as she didn’t introduce herself, took my blood pressure and weighed me before I saw the doctor. I found the whole thing very weird.
I have Aetna Medicare Advantage health insurance through my husband’s employer.
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Exactly same here, although I went three different primary doctors after my old Primary Dr. retired about 7 -9 years ago.
Regarding 'nurse,' I'm guessing those nurse are coming from 'nurse pool,' not regular nurse. My old Dr', nurse was his Nurse, not from 'nurse pool.' She even chatted about per personal life, very friendly and caring.
As for Primary Dr., ... none of three Primary Drs. are like my old Dr. who cares about my overall health.
But, guessing time has changed and I am a sort of accustomed to today's Dr.'s approach and practice.
After all, I'm happy about the current Primary Dr. whose office is close to the place where I live. Easy to get in and get out.
 
I don't think I've ever done the annual wellness check, but I have to go every 6 months anyway for another health matter so I don't think they ( my doctor) bothers with it.

We have a close friend who hadn't seen a doctor for 10 years or more before she got medicare. She did do the welcome to medicare wellness thing. They found out she was diabetic with pretty high sugar levels. Had no symptoms at that point, so she was able to go on meds and now is still doing pretty well. She hasn't had any major complications. This predated the ACA , so she didn't get regular check-ups because she didn't have insurance. Seemed like a good thing to me.
 
I avoid physical exams. If I feel some discomfort, I will just make an appointment to see doctors and get treated. If there is some big problem, I just hope it ends soon.
 

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