Medicare Supplement Plans, also known as Medigap, can help cover some of the costs associated with annual physicals and preventive care.
Many Medicare Supplement Plans cover the Part B deductible, which is the amount you pay out-of-pocket for doctor visits and other medical services.
Some Medicare Supplement Plans, such as Plan G, cover the Part B deductible in full, while others, like Plan F, cover it but also include additional benefits.
Medicare Supplement Plans can help reduce your out-of-pocket costs for annual physicals and preventive care, but it's essential to review your plan's specifics to understand what's covered.
Medicare Supplement Plans
Medicare Supplement Plans can be a lifesaver when it comes to covering out-of-pocket costs for Medicare-approved services. In 2024, the standard Medicare Part B deductible is $240 per year.
Medicare Part B coinsurance is another cost to consider. Once your Part B deductible is met, Medicare pays 20 percent of the Medicare-approved amount for a service.
Your monthly Medicare Part B premium is also something to factor in. In 2024, the standard Part B premium is $174.70 per month.
Medicare Supplement Insurance, also known as Medigap, can help cover some of these out-of-pocket costs. It's worth noting that each of the 10 standardized Medigap plans available in most states provides at least partial coverage for the Medicare Part B coinsurance or copayments you might face.
Here are the 10 standardized Medigap plans that can provide partial coverage for Medicare Part B coinsurance or copayments:
What Medicare Covers
Medicare covers the Medicare Annual Wellness visit every 365 days, and it's completely free for any Medicare member.
Annual physical exams are not covered by traditional Medicare, which can make them quite expensive, especially if they require testing.
BlueCross BlueShield of South Carolina Medicare Advantage plans, however, do cover annual physical exams, and members won't have to pay a dime, including for any tests involved.
Understanding Annual Physicals
Annual physicals are an essential part of maintaining good health, but what do Medicare supplement plans cover when it comes to these exams? Medicare doesn't cover annual physical exams, which can be expensive and often require testing that increases costs.
Your Medicare Annual Wellness visit, on the other hand, is covered every 365 days at no cost to Medicare members. This visit is a yearly check-in with your doctor where you can review or update your medical history and learn about preventive services that could be beneficial to you.
While your Annual Wellness Visit and annual physical exam are not technically physical exams, they accomplish similar things. Your Annual Wellness Visit includes a review of your medical history, a review of your prescription medications and providers, height, weight, and other routine physical examinations and measurements, and a screening schedule for preventive services you should undergo.
Here are the key differences between your Annual Wellness Visit and an annual physical exam:
- Annual Wellness Visit: A yearly check-in with your doctor to review or update your medical history and learn about preventive services.
- Annual Physical Exam: A comprehensive exam that may include testing and can be expensive.
Medicare Advantage plans, like BlueCross BlueShield of South Carolina, may cover annual physical exams, but it's essential to check with your provider to confirm coverage and any costs associated with the exam.
Medicare Wellness Visit
Your annual wellness visit is a yearly check-in with your doctor where you can review or update your medical history and learn about preventive services that could be beneficial to you. It's covered by Medicare Part B.
At your annual wellness visit, you'll meet with your doctor to develop a personalized prevention plan, which can help you stay healthy. This plan includes a review of your medical history, a review of your prescription medications and providers, height, weight, and other routine physical examinations and measurements.
The plan also includes a screening schedule for preventive services you should undergo, and other personalized health advice. Although your welcome to Medicare visit and your annual wellness visit are not technically physical exams, in many ways they accomplish similar things.
Here are some key benefits of your annual wellness visit:
- A review of your medical history
- A review of your prescription medications and providers
- Height, weight, and other routine physical examinations and measurements
- A screening schedule for preventive services you should undergo
- Other personalized health advice
Note that Medicare covers the Medicare Annual Wellness visit every 365 days, and it's no cost to any Medicare member.
Frequently Asked Questions
Why are routine physicals not covered by Medicare?
Routine physicals are not covered by Medicare because they are considered non-medically necessary, unless a specific medical need is identified. However, Medicare may cover individual blood tests or services as part of a physical exam if medically necessary.
Sources
- https://www.medicaresupplement.com/coverage/does-medicare-cover-physicals/
- https://www.southcarolinablues.com/web/public/brands/sc/blog/categories/health-insurance-101/2023/medicare-advantage-annual-wellness-physical-visit/
- https://www.medicare.org/articles/does-medicare-cover-annual-physicals/
- https://www.sdinsured.com/2023/02/medicare-wellness-visit-or-physical-exam-knowing-the-difference-may-save-you-money/
- https://www.medicaresupplement.com/coverage/medicare-annual-wellness-visit/
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