Alert
Close

Top the Trizzle leaderboard by 5 p.m. Friday to win a $100 gift card! Learn more

HIGHLIGHTS

Open

learning centers

Get smart strategies for managing health conditions.


Arthritis

Heart Disease

Diabetes

Most Popular

Viewed

What You Need to Know About the New, Free Medicare Checkup

The new benefit isn't what you might think

En español | When is a physical not a physical? That's what William Schmitz wanted to know after he went to his doctor for what he thought would be a free Medicare exam and was later charged $70 for it. Other patients who had the same experience say they've been charged up to $400

Have Medicare? Medicare Open Enrollment runs from October 15 – December 7. Review your medical and prescription drug coverage options

Drawing of a doctor giving a reflex exam to patient. What is covered under a Medicare wellness exam?

Be careful what you ask for. A Medicare "wellness exam" differs from a "physical exam." — llustration by: Jon Krause

Schmitz, a retired engineer from Portland, Maine, was pleased when he read that, under the new health care law, Medicare had begun covering annual physicals free of charge. But after he had one, Medicare denied his claim.

"When I asked the doctor's office what had happened, they clued me in that I was mistaken about the difference between [Medicare's] wellness exam and a physical," he says. "I was upset that the way it's set up is misleading."

The official handbook, "Medicare & You 2011," says that "Medicare covers two types of physical exams — one when you're new to Medicare and one each year after that." It describes these as the initial "Welcome to Medicare" physical exam and the yearly "wellness" exam.

Both have value, but neither are what patients and physicians usually regard as a physical. "The annual wellness visit can be performed without the patient ever having to undress, and that sums up the problem," says Yul D. Ejnes, M.D., a practicing internist in Rhode Island and chair of the board of regents of the American College of Physicians.

The federal Centers for Medicare & Medicaid Services (CMS) now acknowledges that using the term "physical exam" in the 2011 handbook is misleading. "This description of the wellness visit has been clarified in the latest Medicare handbook, which is currently being printed for mailing in September," CMS spokesperson Ellen Griffith tells the AARP Bulletin.

Until Jan. 1 this year, Medicare did not cover any routine exams except for the "Welcome to Medicare" exam for new beneficiaries. The Affordable Care Act created the once-a-year wellness visit as a new benefit, paying doctors to perform it and making it free to patients. By the end of June, Medicare had paid for nearly 1 million such visits, according to CMS.

Next: How do you get a free checkup? >>

Topic Alerts

You can get weekly email alerts on the topics below. Just click “Follow.”

Manage Alerts

Processing

Please wait...

progress bar, please wait

Tell Us WhatYou Think

Please leave your comment below.

Discounts & Benefits

From companies that meet the high standards of service and quality set by AARP.

Woman trying on glasses in optometrists shop

Members save up to 60% off eye exams and 30% off eyeglasses at Pearle Vision.

Prescription medication spilling out of bottle

Members get a free Rx card from AARP® Prescription Discounts provided by Catamaran.

AARP/Walgreens Wellness Bus Stops in Clarksdale, MS

Members can get exclusive points offers from Walgreens and Duane Reade.

Caregiving walking

Caregiving can be a lonely journey, but AARP offers resources that can help.