Family Medicine

Senior Wellness

Senior Wellness visits allow for a conversation between you and your doctor to discuss your health history and any concerns you may have regarding your health, and to review your medications and immunizations. It also is a time when you and your doctor review your existing health problems; determine what health issues may become a concern in the future and how to prevent them.

The goals of these visits are to create a complete personal and family health history and to help prevent future health problems. Potential benefits of annual senior wellness visits include:

Enhancement of patient activation and engagement with their primary care providers
Identification of health risks, such as depression; behavioral counseling, such as dietary counseling
Preventive care services, such as vaccinations or cancer screenings.

SENIOR WELLNESS COVERAGE:

Medicare Covers Visit

Initial Preventive Physical Examination (IPPE)

  • Review of medical and social health history, and preventive services education
  • Covered only once, within 12 months of Part B enrollment
  • Patient pays nothing (if provider accepts assignment)

Annual Wellness Visit (AWV) Visit

  • To develop or update a personalized prevention plan, and perform a health risk assessment
  • The wellness visit can be done by your physician or another member of the healthcare team such as a Physician’s Assistant or Nurse Practitioner.
  • Covered once every 12 months
  • Patient pays nothing (if provider accepts assignment)

 

Item that will need to be completed during visit:

  • Wellness Form

* The wellness exam only covers the topics detailed above. Additional charges may occur if other issues are addressed during a Patients wellness visit.

Well vs Sick Visits:

Sick Visit- An office visit for an acute problem, flare up of a chronic problem or visit for follow up of chronic problems (Diabetes, cholesterol, blood pressure etc.)

Well Visit- An office visit for a routine physical exam or yearly health maintenance exam.

Well/Sick Visit- A combination visit of a routine physical exam in which a chronic issue is addressed.  For example, you present today for a well visit and you have an acute or chronic issue you would like addressed, this is considered a combination visit and will be billed differently than just a well visit or just a sick visit.

Why is Billing Different? The office visit is billed differently to account for the additional time, expertise, and documentation required for a combination visit.

How this Affects YOU- Although many insurance companies acknowledge the sick/well visit combination, some of them require two co-pays or have additional cost applied to your annual deductible.  Please contact your insurance carrier to determine how your insurance will cover a sick visit, a well visit and a combination visit.