Discovering the Wellness and Prevention Benefits in Medicare

Wellness and prevention benefits can be found in Part B of basic Medicare, in MediGap (supplement) plans, and in Medicare Advantage plans.

Basic Medicare’s Part B (Out-Patient Medical Services)

Has a one-time ‘Welcome to Medicare‘ office visit that needs to be scheduled during the 12 months following your enrolling in Part B.  This visit has no copay and includes a review of your medical and social health history, education, and counseling about preventive services, certain screenings, shots, and referrals for other care if needed.  This visit, however, does not include a physical exam. 

Part B enrollment also provides an annual wellness benefit: a yearly appointment with your primary care provider to develop or update a personalized prevention plan based on your current health and risk factors.  This service includes a health risk assessment, routine measurements, health advice, and referrals to health education and preventive counseling services.

Both the ‘New to Medicare‘ and the Annual Wellness Services are provided to prevent disease and disability by having a personalized disease prevention plan.

MediGap

Sometimes called “supplement” plans, primarily cover out-of-pocket costs with Parts A and B of basic Medicare and do not include special benefits that go beyond Medicare.  Examples of these extended benefits may include gym memberships, emergency foreign travel coverage, an over-the-counter allowance, and hearing, vision, acupuncture and chiropractic services.  Typically, these added benefits can add to the premium of the MediGap plan. 

Medicare Advantage

Plans have a prime focus on wellness and prevention benefits without any cost-sharing with a plan member.  These include annual wellness visits, health screenings and counselling, vaccinations and cognitive impairment testing, fitness programs, nutrition counselling, dental coverage, vision/hearing exams, and coverage.  These benefits are designed to help plan members stay healthy and manage their health proactively.

Contact CPS Medicare Advisor, Daniel E. Griset, CLU, at (949) 225-7144 or dgriset@cpsinsurance.com for assistance navigating your client through the Medicare space.