A wellness visit, or annual physical, is a preventative care appointment designed to keep you healthy. It’s also a way for your doctor to check in with you on your health and get a sense of how things are going.
However, this type of visit can be a bit confusing for Medicare beneficiaries. Because the line between a wellness visit and a regular physical exam is very thin, there’s a chance your doctor could bill you for lab work or other services that Medicare won’t cover.
Medicare
Medicare offers a free annual wellness visit to beneficiaries who have Part B, the most common Medicare plan. The visit includes a health risk assessment, height, weight and blood pressure check, review of medical history and family medical history.
The physician will also update a preventive care plan and screening schedule for the upcoming year. They may offer advice on weight loss, smoking cessation and other prevention strategies.
However, if you need an emergency or other treatment during the visit, you’ll be responsible for paying the cost of that service. Some Medicare plans charge a co-payment for wellness visits that identify other medical conditions or require additional tests.
The annual wellness exam is an excellent way for Medicare beneficiaries to stay healthy and take control of their care. It’s an extra tool in their health care toolbox, and it can save them money on hospital and doctor bills down the road.
Medicaid
Medicaid provides medical care to many children, parents, pregnant women, seniors and people with disabilities. It is a federal-state partnership that is funded jointly by the U.S. government and individual states.
Medicaid covers a wide range of healthcare services, including inpatient and outpatient hospital care, physician services, laboratory and x-ray services, home health care and nursing facility care. It also provides a wide range of optional benefits.
The Federal government contributes a fixed percentage of each state’s Medicaid spending to help pay for the costs of the program. In addition, Congress has raised the matching rate twice during recessionary periods to help strengthen support for states.
The majority of Medicaid enrollees receive their benefits through private managed care or integrated care plans. Others are enrolled in traditional “fee for service” (where providers are paid directly).
Private Insurance
The vast majority of Americans receive their medical coverage through private health insurance, which is a type of insurance that is sold through a variety of channels. These include employer-sponsored plans and individual/family insurance plans purchased by consumers.
Employer-sponsored group health plans are the most affordable way to purchase private health insurance. They usually subsidize premium costs and can save you money if you qualify for a subsidy from the federal government.
Another option for affordable private coverage is to purchase a plan through the marketplace/exchange in your state under the Affordable Care Act (ACA). These plans can be more expensive than those offered by employers, but they may be eligible for premium tax credits and cost-sharing reductions.
Medicare has a unique annual wellness visit that was launched in 2014. If you are eligible for this yearly checkup, it is free and is designed to help you stay healthy and prevent diseases.
Self-Insured
Most health plans cover a set of free preventive services like screening tests and vaccinations. Getting the right kind of care at the right time can save you money in the long run and improve your health.
What if you had the funds and the inclination to forgo the big insurance companies? Self-insurance may sound risky, but in practice it can be a no-brainer. Depending on the size of your team and the type of insurance you choose, you might be able to shave a few hundred dollars off your premiums per year.
To get the most out of your plan, you need a way to monitor and report on performance so you can keep your costs in check. This can be accomplished by integrating analytics into your employee benefits platform and using the data to guide strategy. SmartCompliance provides the tools and resources you need to make informed decisions that will keep your business afloat, healthy and happy.