Contact: Carrie Burkett, carrie.burkett@mainehealth.org / 603-356-5461 ext. 2264
or Tim Kershner, Timothy.Kershner@MaineHealth.org / 603-356-5461 ext. 2198
When it comes to preventive health care for older adults, the Medicare Annual Wellness Visit is essential. These annual visits, fully covered by Medicare, are designed to screen for a long list of factors that can have an impact on health and longevity.
Katie Villarevia, a nurse practitioner at MaineHealth Primary Care North Conway, explained that during a wellness visit, patients have a discussion with their provider that moves through a series of questions and screenings to assess their current state of health. The assessment includes a review of medical and family history, a list of current medications, questions around social determinants of health, and other risk factors for chronic diseases.
“It's a visit dedicated to a very thorough review of a patient's health and history without distraction from acute concerns,” Villarevia said. Providers look at health history, talk about general wellness recommendations, and make sure any recommended screenings, labs, imaging, or other diagnostics have been scheduled. “For example, a patient I saw had some imaging done and it was noted that they have arterial plaque. I documented this in their chart so we can work on lowering cholesterol and therefore cardiovascular risk. In these visits we make sure the chart accurately represents the patient and the patient’s health so we can continue to provide great care.”
Many people think the Annual Wellness Visit is the same as a full physical exam. “Someone who is accustomed to getting a physical or coming in for problem-based visits might be confused by the wellness visit,” explained Villarevia. “If you answer no to a lot of the screening questions, you can count yourself lucky!”
The primary benefit of the Annual Wellness Visit is to identify potential health risks early and arrange for timely intervention and management. “If something is flagged during the visit, say food insecurity, we have food bags we can offer. We have the Lend a Hand program where members of my team can meet with you to plug you into the right resources. We have a community health worker if you’re experiencing cognitive changes. She can guide you and your family to find the right local programs to help.”
Medicare beneficiaries are eligible for a wellness visit once every 12 months. The visit is covered under Medicare Part B with no out-of-pocket cost for the patient, making it an accessible and valuable service for preventive health care.
“A point of confusion for some patients happens when they bring up a specific health problem at the appointment,” said Villarevia. “I am happy to examine the problem, but I explain to the patient that we are adding something different into the appointment now so they may be billed a copay. If there is a significant problem or multiple problems that need addressing, we may postpone the wellness visit.”
While the Medicare Annual Wellness Visit requires no out-of-pocket costs, a problem-based visit is coded separately from the wellness visit. Additionally, Medicare does not cover an annual physical exam. If a patient wants to schedule a physical, they are billed for the full cost of the visit unless they have an additional policy that covers a physical exam.
Medicare wellness visits are an important tool in maintaining health and preventing disease. By taking advantage of this benefit, Medicare beneficiaries can ensure they are on track for a healthier future. To learn more about the Annual Wellness Visit, go to MaineHealth.org and search Medicare.
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About MaineHealth Memorial Hospital
MaineHealth Memorial Hospital is a 25-bed Critical Access hospital serving the Mount Washington Valley of northern New Hampshire and western Maine. MaineHealth Memorial Hospital has earned a reputation among local residents and visitors for providing quality, compassionate and personalized care to its patients.
MaineHealth Memorial Hospital includes a robust array of health care services including primary and specialty care services and therapies, emergency care, a birthing center and surgical services. Its care team of 525 includes physicians and advance practice providers who are among the more than 2,000 providers who are part of the MaineHealth Medical Group. Memorial patients have access to onsite care in oncology, cardiology, vascular and pulmonary medicine. MaineHealth Memorial Hospital also partners with several local organizations to provide outreach and educational services supporting the health of our patients and community.
MaineHealth Memorial Hospital is part of MaineHealth, a not-for-profit integrated health system whose vision is, “Working together so our communities are the healthiest in America.” As part of the MaineHealth family, MaineHealth Memorial Hospital is able to offer patients a comprehensive network of care that includes world-class specialists, a Level 1 Trauma medical center, comprehensive pediatric care services, an extensive behavioral health care network, diagnostic services as well as home health, hospice and senior care services.