Medicare Annual Wellness Visit Required by Law?

[GANS1110]

Trying to determine if medicare patients have the right to refuse the annual wellness visit or is it mandated by law?

[moreorp]

I agree. So much of the information they ask for, as far as I’m concerned, is none of their business!

[GailL1]

@moreorp 

No treatment or health review (Welcome to Medicare Preventive Visit or the Annual Wellness Visit) are required by Medicare.  However, if you believe in preventive care especially the items that are covered under Medicare with NO OUT OF POCKET, then you might want to do one or the other of these health review so the doc can begin to schedule the preventive measures.  Hope that the doc knows what’s covered too.

Of course, you can always look them up on the Medicare site or if an immunization on the CDC site for those recommended for the age group.  

Any new doc that you might go to after going on Medicare, especially one’s PCP, needs to know about you - your health, your body, your medical history and your family’s medical history to treat you fully.

Now if you are of the type that doesn’t believe in preventive care or immunizations - or how these other things could influence your personal health - then don’t get them done - all the better since the program will not have to pay for you to have this care and it will save the program money.

On the other hand, if you don’t get your shingles vaccination(s) - it is a group of (2) - then if you come down with shingles, you would probably would want treatment - right?  Treatment for the pain and anguish that you would be going thru - and god forbid that it gets into your eyes.  

Your choice, your health - 

[TRL1111]

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@GailL1 wrote:

On the other hand, if you don’t get your shingles vaccination(s) - it is a group of (2) - then if you come down with shingles, you would probably would want treatment - right?  Treatment for the pain and anguish that you would be going thru - and god forbid that it gets into your eyes.  

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Actually, I did get shingles a couple of years before I was eligible for Medicare.  It was a very mild case.  I could not only see the rash but I had sensation that it was there, but no pain at all.  Only itching.  I went to a doc-in-a-box because my boyfriend said, "Could that be shingles?"  I have no idea where he got that, but it turned out he was right.  I got the prescription but I was right on the edge of the timeline for it being effective, and I think it just ran its course.

But other than that I'm very healthy.  I don't have a primary care physician, and haven't gone to a doctor for a regular old physical in decades.  In fact, the only time I ever went to the doctor at all was because they held women hostage if they wanted birth control pills.  

I'm very health literate.  I hit the jackpot when it comes to genes, except for hereditary hearing loss that I know more about that any PCP would.  I don't have any risk factors except for a horrible diet that makes me happy and hasn't made me fat or given me diabetes.  

My health doesn't need any oversight right now.  If/when it does, then I'll be a partner with a doctor in making decisions.  But until then, I'm completely capable of looking after myself.  So a wellness evaluation visit holds no appeal for me whatsoever.  And I thank my lucky stars I'm in a position to feel that way.

And as you pointed out, my fellow Original Medicare beneficiaries should thank me because I'm saving Medicare and AARP/UHC a ton of money.

[TRL1111]

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@moreorp wrote:

I agree. So much of the information they ask for, as far as I’m concerned, is none of their business!

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I'm torn.  If I were a doctor, I'd want to know everything I could about my patients.  But as a patient, I don't think it's any of their business.  Then again...

I went to this link that Gail1 provided:

cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/preventive-services/medicar... 

I think it's a really good explanation of what these visits, and their questions, are designed to do, one of which is to achieve health equity.  As someone who has never suffered from health inequity, I don't need this, but I know that position is privileged.

I have to do all sorts of stuff I don't "need" but everybody has to do it because there are people who do need it.  Like multiple protections from being scammed and the like--no way I'm going to be scammed, but I still have to jump through the hoops because others need the protection and there's no way to tell who needs it and who doesn't.

In the meantime, I'm not planning to do any sort of wellness visit.  If a doctor I want to see requires it, I'll find another doctor if possible.  If it's not possible, I'll suck it up and do it.

[GailL1]

@TRL1111 wrote 

I'm torn.  If I were a doctor, I'd want to know everything I could about my patients.  But as a patient, I don't think it's any of their business. 

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Like what?  

[moreorp]

What I don’t believe in is forcing any patient to do anything that don’t WANT to do. For me-if I want help for something, I will ask for it!!

[moreorp]

This is not preventive MEDICINE. Preventive medicine is physical screenings, vaccinations, i.e. - PHYSICAL EXAMS. This AWV feels to me like doctors intruding into personal private lives to “advise” them about how they can live more safely.
I’m 71 years old and I have lived my life as safely as I can or care to and I don’t need someone intruding into my personal home life telling me I need some kind of “counseling”. I probably know more about nutrition, exercise, and quitting smoking than people who would be “counseling”me!!!

This is not medical - it is intrusion into personal private lives that I, among others as I see here, is not welcome.

[roberte127682]

very intrusive. Primary Care doc is now part of a large hospital group in Eastern PA.   I make appointments for 6 month follow ups for relatively minor conditions.  Online the appointments start out as short office visits,  which mysteriously change to Medicare Wellness visits during the ensuing months.  I then call the office and they do switch it back to an office visit,  however in a few weeks it then changes back th a Medicare Wellness Visit.   The office often calls to ask when I’m going to schedule the AWV…. Which I decline.  It’s like being “hounded” by bill collectors fir something I really don’t want.  It’s why I go to NY for any specialist care I need.

[AlyceH499178]

do i agree!!!!

[sktn77a]

Just make sure they code your visit as an Annual Wellness Visit and NOT an annual/routine physical examination- Medicare will NOT pay for an annual/routine physical.  Any new/ongoing medical issues can be addressed - they are not considered an annual physical.