# [2007] Welcome to Medicare Physical Exam Part B



## Miss Marty (Feb 22, 2007)

*
One-time "Welcome to Medicare" Physical Exam *

If your Medicare Part B coverage begins on or after January 1, 2005,

Medicare will cover a one-time preventive physical exam within the first 
six months that you have Part B. The exam will include a thorough review 
of your health, education and counseling about the preventive services 
you need, like certain screenings and shots, and referrals for other care.

The "Welcome to Medicare" physical exam is a great way to get up-to-date on important screenings and shots and to talk with your doctor about your family history and how to stay healthy.


http://www.medicare.gov/Health/physicalexam.asp?PrinterFriendly=True


http://www.medicare.gov/


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## Miss Marty (Feb 22, 2007)

*Remember!*

*
Once you enroll in Part B, it's important to schedule your 
"Welcome to Medicare" physical exam right away. *

Medicare will only cover this physical exam if it occurs within the first six months that you have Part B. If your doctor thinks this six month period has passed, he or she should give you a notice that says Medicare probably won't pay for this service. 

If you still want to get the service, you will be asked to sign an agreement that you will pay for the service yourself if Medicare doesn't pay for it.  This is called an Advance Beneficiary Notice.


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## Miss Marty (Oct 27, 2007)

*Welcome to Medicare Visit (WMV)*

*
Medicare Begins Covering New Preventive Health Benefits*

On January 1, 

Medicare began offering a new benefit: 

The Welcome to Medicare Visit (WMV) that will include cholesterol and diabetes screening tests. The Medicare Modernization Act ( MMA ) permits payment for one initial preventive physical examination within the first 6 months after the effective date of the beneficiary’s first Part B coverage period, 
(but only if that coverage period begins on or after January 1, 2005).

MA defines an ‘‘initial preventive physical examination’’ to mean physician and certain qualified non-physician practitioner services consisting of all of the following:   

Review of the individual’s comprehensive medical and social history. 

Review of the individual’s risk factors for depression based on the use of an appropriate screening instrument. 

Review of the individual’s functional ability and level of safety that is, at a minimum, a review of the following areas: hearing impairment, activities of daily living, falls risk, and home safety. 

An examination to include measurement of the individual’s height, weight, blood pressure, a visual acuity screen, and other factors as deemed appropriate by the physician or qualified non-physician practitioner, based on the individual’s comprehensive medical and social history and current clinical standards. 

Performance and interpretation of an electrocardiogram. 

Education, counseling, and referral, as appropriate, based on the results of the previous five elements of the initial preventive physical examination. 

Education, counseling, and referral, including a written plan provided to 
the individual for obtaining the appropriate screening and other preventive services, which are separately covered under Medicare Part B benefits; 
that is, pneumococcal, influenza, and hepatitis B vaccines and their administration, screening mammography, screening pap smear and screening pelvic exams, prostate cancer screening tests, diabetes outpatient self-management training services, bone mass measurements, screening for glaucoma, medical nutrition therapy services, cardiovascular screening blood tests, and diabetes screening tests. 

Physicians may bill for a more extensive office visit when performed at the same time as the physical, as long as the services are medically necessary.


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## Miss Marty (Mar 28, 2008)

*FEHB Health Insurance or Social Security Medicare B*

*
Which Medical Insurance Coverage is best* 

Signing up for Social Security Medicare Part B at retirement or
FEHB The Federal (reitred) Employees Health Benefits Program


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## AwayWeGo (Mar 28, 2008)

*I Don't Think It's An Either / Or Situation.*




Marty Giggard said:


> *
> Which Medical Insurance Coverage is best*
> 
> Signing up for Social Security Medicare Part B at retirement or
> FEHB The Federal (reitred) Employees Health Benefits Program


I am an old retired U.S. federal bureaucrat covered under FEHB _and_ covered under Medicare A & B (i.e., hospitals & doctors). 

Starting the month I turned 65 Medicare became my _primary_ health coverage plan & my FEHB plan became my _secondary_ (i.e., "Medi-gap") health coverage plan.  That is to say, my FEHB plan is supposed to pay for every covered medical expense that Medicare doesn't pay for -- co-payments, Medicare deductible, etc. 

Medicare premiums come out of my monthly federal retirement benefit payments.  Ditto monthly premiums for my FEHB plan -- & not only that, the amount of the FEHB premium did not go down when the FEHB plan became secondary even though Medicare carries most of the load. 

I did schedule & take my free Medicare physical -- has to be done during the enrollee's 1st 6 months under Medicare, as I understand it.  Got a bunch of lab tests done, had EKG, took a treadmill-style stress test, got prodded & poked & peered at by the doctor, etc.  Heart OK.  Liver & kidneys OK.  Lungs OK.  Blood pressure slightly elevated -- taking HCTZ for that.  Cholesterol OK.  PSA questionable -- need to get that retested in 6 months.  Blood sugar OK.  Some hearing loss.  Overweight -- need to exercise more. 

So it goes -- old & fat & deaf with high blood pressure.  But The Chief Of Staff still thinks I'm cute.  Go figure

-- Alan Cole, McLean (Fairfax County), Virginia, USA.​


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## Miss Marty (Jul 20, 2011)

*Medicare*

*
Free Screenings to Help Fight Cancer*

Medicare & Medicaid Services 

You can take control of your health with Medicare’s preventive benefits. Get free screenings to detect cancer early, when treatment works best. Preventing and stopping the progress of chronic diseases improves your health and quality of life. It also helps Medicare spend less on long-term illnesses that could have been prevented. 

*If you have Medicare, you can get the following screenings:*

      Colorectal cancer screenings – four different screenings to detect colon and rectal cancers, each is covered as needed for all people age 50 and older 

      Prostate cancer screenings – covered for all men age 50 or older 

      Mammograms – screenings to detect breast cancer, covered for all women age 40 or older 

       Pap test and pelvic exams – screenings to detect cervical and vaginal cancers, covered for all women 

       Smoking cessation counseling – help quitting smoking, to help prevent lung, throat, and other cancers; covered for all people who use tobacco 

Call your doctor’s office to set up your yearly preventive visit, where you can ask about any risk factors that may affect you, and schedule your preventive screenings. Your doctor can also help you keep track of when you should get screenings and which kinds are right for you.


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## rapmarks (Jul 20, 2011)

I thought the law changed and you can get a physical every year. I got a physical this year.  Medicare paid 100 per cent and then the doctor added an office visit charge, medicare paid 80 percent.  My supplemental insurance refused to pay the rest.
The doctor ordered a lot of tests and i thought it was just a big bother.  Turns out that she found cancer with one of the tests and the pre op for surgery required an ekg and a chest xray within the last 6 months and the docter had ordered those tests too, so what i thought was a bother turned out to be needed.
Also the pap test is only covered evsery two years, but an exam is covered every year.

I am trying to find out if the mamogram has to be a year and a day or just the same calendar month.  The year and a day rule is really screwing me up as far as scheduling.


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## Miss Marty (Jul 20, 2011)

*Medicare Made Simple - Countdown to Medicare*

*
Get to Know Medicare: The Basics* 

Original Medicare is a federally funded program
that pays for many health care services and 
supplies.  However, it may not cover all of your
health care needs and there are set costs that you 
must pay, such as coinsurance and deductibles. 
_
The Original Medicare program has two parts _

*Part A Hospital Insurance*

Part A Hospital Insurance helps cover inpatient 
care in hospitals and skilled nursing facilities.  It also 
covers hospice care and some home health care.

_Most_ people _don`t _pay a premium for Part A
because it has already been paid for through
payroll taxes while working.

*Part B Medical Insurance *

Part B Medical Insurance helps cover doctors
services and outpatient hospital care.  Is also 
covers some other medical services that Part A
does not cover, such as x-rays, emergency care, 
some services of physical and occupational 
therapists, and some home health care.

_Most _people pay a monthly premium for Part B.


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## "Roger" (Jul 20, 2011)

Thanks for the posting.  I might add that if you are now on Medicare, consider getting a pneumonia vaccination.  (Highly recommended for people over 65 and covered by Medicare B.)


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## MULTIZ321 (Jul 20, 2011)

Miss Marty said:


> *
> Get to Know Medicare: The Basics*
> 
> _Most _people pay a monthly premium for Part B.




 My Medicare enrollment began July 1, 2011.  I received my first invoice from Medicare and was shocked at the amount of the bill - $460 and change. I called Medicare to inquire about the amount of the bill. They told me the Part B Premium is billed quarterly - so the amount of the bill was the monthly premium x 4.   

I didn't know that's how the Medicare billing was handled and have adjusted my savings pattern to account for this uptake.

Just a heads up for those that might not be aware of this.

Miss Marty - thanks for posting the Medicare info - very timely.

Richard


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## TUGBrian (Jul 20, 2011)

good timing, my father was telling me the one thing hes found more complicated than learning about timeshares...was medicare/aid..and that he wished there were a "MUG" group  lol


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## fnover (Jul 20, 2011)

Medicare Rights Center is a good resource for all things related to Medicare.
http://www.medicarerights.org/


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## deemac (Jul 21, 2011)

*thx*



fnover said:


> Medicare Rights Center is a good resource for all things related to Medicare.
> http://www.medicarerights.org/



THANK YOU for this info,


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## bogey21 (Jul 21, 2011)

MULTIZ321 said:


> My Medicare enrollment began July 1, 2011.  I received my first invoice from Medicare and was shocked at the amount of the bill - $460 and change. I called Medicare to inquire about the amount of the bill. They told me the Part B Premium is billed quarterly.......



My Medicare Part B Premium is deducted from my Social Security check (actually direct deposit).  Note that the Part B Premium is means adjusted based on one of your prior year tax returns.  The higher your income in that year, the higher your Part B Premium.

George


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## rapmarks (Jul 21, 2011)

my social security is not enough to cover Medicare, so i get a bill in january for the entire year   it is well over 1000 and comes at a bad time of the year.  My husband gets no social security and can pay for his medicare monthly, but I can't (even though he is covered under my work record)


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## teepeeca (Jul 22, 2011)

-----------------------------------------------------------------------===== One-time "Welcome to Medicare" Physical Exam ======

This is "good information"---HOWEVER---I wonder how many people actually got that "notice" ???  I'm an "old fogey", and "know" I didn't receive any notice about a physical.

Actually, I'm lucky, and my "real medical providers" makes sure I'm "OK".  (Did I miss something???---probably !!!---LOL !!!)

Tony


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## Miss Marty (Sep 8, 2011)

*Q: For Federal Retirees -  Medicare Part B - FEHB - Medicare Advantage*

*
Which is better, FEHB a federal retiree plan or Medicare Part B?* 

Example:

Q.  I could sign up for Medicare Part B but I’m not sure I need it because my spouse is a retired federal employee and we plan on maintaining his/her FEHB Blue Cross-Blue Shield coverage. On the other hand, our friends say that Part B helps with out-of -pocket expenses. Which is a better choice (for us)?

A.  While most retirees must take Part B once they or their spouse are no longer actively employed, such is not the case for federal retirees. You basically have three choices, all with pros and cons. (Assuming that in all three cases, you will sign up for Medicare Part A. It’s free so there’s no reason not to.)

Choice 1. _Don’t take Part B_ and continue coverage under the FEHB retiree plan. This will save you the cost of the Part B premium ($115.40 a month this year for most people but more for higher-income beneficiaries). If you go this route, your FEHB plan will basically function as a Medigap plan for your hospital (Part A) expenses. But for your doctor and drug expenses, you will be responsible for the usual deductibles, copayments and coinsurance of your FEHB plan. The downside of this route is that if you should change your mind later, your Part B premium will be 10 percent higher for every year you could have been in Part B, but weren’t.

Choice 2. _Take both Part B and your FEHB plan_. This will be more expensive because you will be paying two sets of premiums, but your FEHB plan will now function as a Medigap plan for both your hospital and doctor bills, and cover your drugs as it always did. David Snell, director of retirement benefit services for the National Active and Retired Federal Employees Association, suggests that if you go this route, you might investigate switching to a cheaper FEHB plan to save some money.

Choice 3. _Suspend your FEHB enrollment _and sign up for a private _Medicare Advantage_ plan that includes prescription drug coverage. 
 If you are in relatively good health and don’t take a lot of pricey prescription drugs, this might be the cheapest strategy. You’ll have to sign up for Part B to go this route. If down the road you develop expensive health problems that make your plan’s cost-sharing hard to afford, you can re-enroll in FEHB and go back to original Medicare.


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## Miss Marty (Oct 14, 2011)

*Medicare Authorization to Disclose Personal Health Information Form*

If you want someone to be able to call 1-800-MEDICARE on your behalf, 
you need to fill out a “Medicare Authorization to Disclose Personal Health
 Information” form so Medicare can give your personal health information 
 to someone other than you.

This form is used to advise Medicare of the person or persons 
you have chosen to have access to your personal health information.

http://www.medicare.gov/MedicareOnlineForms/PublicForms/CMS10106.pdf

Fill out Medicare Online Form - Print - Sign - Mail  - Completed Form


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## Miss Marty (Nov 19, 2011)

*2012 Medicare and You  for computers Call 1-800-Medicare to Order*

Be sure to order the *"Audio CD"* Medicare and You on Compact Disk
to listen to as you read along with your Medicare and You Handbook


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## Miss Marty (Dec 5, 2011)

*Reminder*

*
Medicare Open Season: *
Last day to change your Medicare plan is December 7, 2011


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## Miss Marty (Jan 16, 2012)

*Medicare*

*
Medicare Monthly Premiums for 2012* 

Type and Amount of Monthly Premium 

Part A - Monthly Premium 
Most people don’t pay a Part A premium because they paid 
Medicare taxes while working. This is called "premium-free."
($451 for people who pay a premium) 

Part A Late Enrollment Penalty
 +10% 

Part A Deductible: *
You pay: $1,156 deductible per benefit period 

Part B - Monthly Premium $99.90 
Higher-income consumers may pay more. 

Part B Late Enrollment Penalty
 +10% for each full 12-month period that you 
could have had Part B, but didn't sign up for it

Part B Deductible: *
You pay $140 per year

www. medicare .gov


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## Miss Marty (Jan 16, 2012)

*Medicare Summary Notice (MSN) Claims*

If you get a Medicare-covered service, you’ll get a Medicare Summary Notice (MSN) in the mail every 3 months. The notice shows all your services or supplies that providers and suppliers billed to Medicare during the 3-month period, what Medicare paid, and what you may owe the provider. 

This notice isn’t a bill. 

A Medicare Summary Notice (MSN) shows all the services or supplies that were billed to Medicare during each 3-month period, what Medicare paid, and what you may owe the provider. 

How to File a Claim

If you're in Original Medicare, doctors and suppliers are required by law to file Medicare claims for covered services and supplies you get. In very rare cases, you may need to file a claim on your own. If you get your Medicare healthcare through a Medicare Advantage Plan, these plans don’t have to file claims because Medicare pays these private insurance companies a set amount every month.


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## Miss Marty (Jan 16, 2012)

*Check Your MSN on MyMedicare.gov*

You don’t have to wait for your MSN to view your Medicare claims. 

Visit www. MyMedicare .gov to track your 
Medicare claims or view electronic MSNs. 

Your claims will generally be available within 24 hours after processing.


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## Miss Marty (Jul 3, 2012)

*Welcome to Medicare Part B - Physical Exams - NCBOE Webinar*

*
Understanding the Annual Wellness Exam*

This "one hour webinar" from the National Center for Benefits Outreach and Enrollment discusses the preventive benefit for Medicare beneficiaries, the Annual Wellness Visit. 

http://vimeo.com/channels/ncboe/27302047


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## Miss Marty (Dec 3, 2012)

*Medicare*

Medicare Open Season Reminder: 
Last day to change your Medicare plan 
is Friday, December 7, 2012.


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## Miss Marty (Feb 6, 2013)

*Medicare Reminder*

1-800-Medicare

If you are in a Medicare Advantage  Plan (C)
you have until Valentines Day Feb 14, 2013 
to leave your plan and switch to Original Medicare 
and join a Medicare Prescription Drug Plan


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## pacodemountainside (Feb 6, 2013)

Miss Marty said:


> 1-800-Medicare
> 
> If you are in a Medicare Advantage  Plan (C)
> you have until Valentines Day Feb 14, 2013
> ...



Why would one  want to this?   One then has to pay for a Plan  "D" and probably a supplement!

My AARP MA  Co-pay on office visits went down  to $10.00.

Yes, next  year may be whole different undertaking!


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## pianodinosaur (Feb 7, 2013)

Miss Marty said:


> *
> Get to Know Medicare: The Basics*
> 
> Original Medicare is a federally funded program
> ...



Very True!!

I strongly advise that all Medicare patients get part B.  Those who do not get part B seem to think that they can get free medical care just by showing up in the ER.  However, once they are admitted to the hospital, they are no longer covered under EMTALA.  Most specialists will refuse to see consults on patients without part B once they have been admitted to the unlucky primary care physician on call for the ER (who will not get paid for his efforts unless the physician is on a salary from the hospital).  You get what you pay for.


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## Miss Marty (May 21, 2013)

*Welcome to Medicare ~ Monthly Tip ~ Bone Density Test*

*
May is Osteoporosis and Prevention Month*

Ask your doctor if you need 
a bone mass measurement.


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## simpsontruckdriver (May 21, 2013)

I worked for United Healthcare during 2012 Open Enrollment (Oct 15-Dec 7), then I worked for UHC Collections. There is one thing everyone MUST know and be ready for: Late Enrollment Penalty. If you're 65, and you do not select either Medicare Part-A or Part-D, as soon as you finally sign up, Medicare will charge you the Late Enrollment Penalty FOR LIFE! I had old farts yell at me, blaming President Obama, calling it a tax, etc, but the fact is, those old farts were wrong. The Medicare Part-D LEP is most common, since most sign up for Medicare Part-A right when offered.

The simple fact is, Medicare Part-D was written by Conservatives. It was signed by (Conservative) President G.W. Bush. Every single Republican who signed the law left office and now works as a healthcare lobbyist. Like I said, they signed the Late Enrollment Penalty into the law, and any one who signs up for a Part-D plan and gets the Late Enrollment Penalty should place blame where it should be: Republicans. And then, suck it up and pay the "tax". If you can't pay it because it is a hardship, the Social Security Administration can assist. *BUT*, if a person gets the Late Enrollment Penalty while they are under 65, the LEP will be withdrawn at 65.

TS


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## Passepartout (May 21, 2013)

All true as far as I can see, but probably could stand some judicious editing to comply with TUG posting guidelines.


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## Blues (May 21, 2013)

simpsontruckdriver, let me just clarify that the late enrollment penalties only apply if *you don't have equivalent coverage* for those years after you turned 65.  My wife recently went to the SS office just prior to her 65th bday, and was advised that since she still has coverage through my health plan at work, she doesn't need to sign up for part B or part D right now (she still needs to sign up for part A).  When I finally retire and lose my health bennies, then she (and I, the younger one) will need to file for parts B and D, and prove that we had equivalent coverage in the intervening years.

At least, I'm hoping that the young clerk at the SS office gave accurate advice.  If anyone knows differently, please post.

-Bob


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## simpsontruckdriver (May 21, 2013)

Right, I forgot to mention equivalent coverage. If a person does not have health insurance with good prescription coverage, they'll be charged the LEP. One interesting tidbit. The Centers for Medicare/Medicaid Services (CMS) is notorious for saying TriCare insureds don't have equivalent coverage, but the truth is, they do.

The big MUST: when a person signs up for a Medicare Advantage (or Part-D) plan, watch your mail. If anything comes from CMS, open it. If it says you didn't have coverage, follow the directions to appeal it (if you did). At that point, it is sent to another company, who will check it. Their decision is final, so if their judgement is you owe, you owe.

TS


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## Miss Marty (Sep 25, 2013)

*Medicare & You*

*
Did you know the "Medicare & You"* 
2014 handbook is available as an e-Book?

www.medicare.gov/publications


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