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Medicare shock!
Old 08-26-2019, 03:15 PM
 
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I qualified for Medicare at the beginning of last January. Today I made my annual physical with my Doc and was told that Medicare doesnt cover any preventative physicals which includes lab work (glucose, cholesterol, etc) and not even annual breast checks, which my hubs quickly volunteered to do. I was shocked that Medicare only pays for a verbal chat with my Doc. Whaaat? My supplement covers preventative physicals but how short sighted of Medicare. I guess they would rather treat people for breast cancer, diabetes, heart attacks and strokes instead...


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Old 08-26-2019, 03:23 PM
 
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Thatís strange as I have had an echocardiogram, my bone density scan, lab work last year and this year all paid for by Medicare. When I had my last visit with my doctor two weeks ago, she did say she had to be careful when she orders things to make sure Medicare will cover it. My supplemental is also billed but usually doesnít pay as Medicare is billed first.
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Old 08-26-2019, 03:26 PM
 
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As I understand it, Medicare covers an initial “Welcome to Medicare” physical that is very complete...I will check and see if I can find a link to post...

Here is the list of what is covered, from Medicare.gov:

https://www.medicare.gov/coverage/pr...ening-services

Be sure to check with your supplemental insurance, which may cover things that Medicare does not.
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Old 08-26-2019, 03:47 PM
 
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I think youíre sharing misinformation. Please read lisaís link. I canít copy, but for example, it explicitly states that Medicare covers 1 mammogram a year.
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An article
Old 08-26-2019, 05:29 PM
 
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https://www.medicare.gov/coverage/ye...ellness-visits


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Another article
Old 08-26-2019, 05:32 PM
 
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https://www.medicare.gov/coverage/we...ventive-visit#
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Medicare
Old 08-26-2019, 05:41 PM
 
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Is it possible that your doctor doesnít accept Medicare? Medicare generally covers all of that.
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Old 08-26-2019, 06:34 PM
 
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A lot of this is wording and coding. Medicare does not pay for “physical”. It pays for “wellness”. It will pay for the blood tests if the physician codes them as diagnostic.

Most doctors just adjust the coding according to the Medicare rules and the patient doesn’t know the difference. Only once did one of my blood tests get rejected. The doctor office recoded and resubmitted, and the bill was paid.

Mammograms are usually one per year for routine ones and the newer machines are covered. An exam in the doctor office is usually paid once every 24 months.

As to supplements, original Medicare supplements usually only cover what Medicare covers. Advantage plans may cover more.
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Old 08-26-2019, 07:43 PM
 
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Thank you all for the information which you posted. My intent was not to intentionally share misinformation but I just expressed my frustration with the system. I appreciate your insights. We never know too much do we?

When requesting an appt, I was asked to designate which type of appt I wanted. I opted for a full general physical which fits my needs better and it will be paid for by my Regence Blue Shield supplement. Im glad I have a good insurance supplement to Medicare.
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Old 08-27-2019, 03:16 PM
 
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I think you had a "welcome to medicare" appointment which is mainly a patient doctor get to know you visit that is free.

Medicare definitely covers mammograms. Also many other screenings. But you do have to make a regular appointment and pay your copay (mine is $15).

Many lab tests are no cost. My medicare advantage plan charges a copay for lab tests per visit - so I pay one copay and can have all the tests needed.

You are allowed one wellness visit per year but there may be a waiting period between your welcome to medicare visit and when you are allowed a free wellness visit.

You should have a detailed list of coverage. If you are on regular medicare (not an advantage plan) and your doctor's office told you that preventative tests are not covered it may be that they want to bill you for full costs and not submit to medicare. If that is the case, time to find another doctor.

I complain about medicare often because I had a health plan that was wonderful and free. But I know that was an exception and most people pay a lot less when they become eligible for medicare. Keep in mind it is a government program so you need to educate yourself and learn how to make it work best for you.


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