When you become Medicare-eligible your health care coverage can change quite a bit and you may be wondering if Medicare covers medical physicals. While this seems like there should be a simple answer to this question, there actually is not. Read below for how it works.
Does Medicare Cover Medical Physicals?
Medicare does not technically cover medical physical exams. They do, however, cover preventive “wellness exams”. Don’t get caught up in the language of “physical”. Medicare covers an annual Medicare Wellness exam that will takes measurements, gives your scheduled screenings, and reviews other health issues, such as personal risk factors. This exam is at no cost to you, as long you don’t require additional diagnostic testing or more frequent screenings than approved by Medicare. The important thing to remember that your wellness exam does not do every screening each year.
Cholesterol screenings are only scheduled once every 5 years under Medicare. If your doctor or other health care provider request that you have more frequent screenings, you may have to pay your Part B deductible, copays, and coinsurance.
Does Medigap Cover Physicals?
Medigap does not cover physicals, either. Remember, don’t get caught up on the word physical. Medicare picks up the costs of your annual wellness exam. Most Medigap will cover the cost of Part B deductible, copays, and coinsurance, you have additional screening as explained above
In the example above, if further cholesterol diagnostic testing and/or more frequent screenings are necessary, your Medigap will pay all or part of these costs (as long as Original Medicare approves the testing).
Does Medicare Advantage Cover Physicals?
Probably not. But the thing is Medicare Advantage may choose to cover your care differently than Original Medicare. With that said, it is probably still unlikely that Medicare Advantage will cover a “physical”, but will probably just cover the costs of your annual wellness exam. You will most likely still be on the same schedule for preventive screenings.
To learn more about Medigap and Medicare Advantage call a Senior65 agent at 800-930-7956.