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Medicare pays for many preventive services in order to aid you in staying healthy. Preventive services can find problems early and can help keep you from getting certain diseases or illnesses. These services include exams, lab tests, and screenings. One of these services is the "Welcome to Medicare" Physical Exam.
What is the "Welcome to Medicare" Physical Exam?
Medicare's Initial Preventive Physical Examination (IPPE), also known as the "Welcome To Medicare" Physical Exam, is a one-time exam paid for by Part B coverage. The IPPE covers a thorough review of your health along with detailed counseling of preventive services. The exam is a great tool for getting up-to-date on important screenings and shots that you may need. Medicare does not cover routine physical exams.
During the exam, your doctor will:
- Record your medical history
- Check your blood pressure
- Check your weight and height
- Check your vision
- Give you an Electrocardiogram (EKG) or schedule one for you
- Make sure you are up to date on your shots
- Educate you on current preventative services
Depending on your general health and medical history, your doctor may order additional tests, give you referrals for additional care, and give you advice on how to prevent disease, improve your health and stay well.
Why Should I Have The Exam?
This "Welcome to Medicare" exam helps the health care provider identify risk factors that may be linked with various diseases at earlier stages. There is usually a better outcome when diseases are detected early. This physical exam consists of an examination, an EKG, education, counseling and referral to other screening and preventive services covered by Medicare.
When Should I Schedule the Exam?
It is important to schedule your appointment immediately after enrolling in Medicare Part B. After your twelfth month anniversary of enrolling, you will be responsible for the charges of the physical exam. If twelve months pass and you still wish to receive the exam, your doctor will have you sign an Advanced Beneficiary Notice stating that you are aware that you will be responsible for the charges.
How Much Will I Pay?
You pay for 20% of the Medicare-approved amount. You must pay the annual deductible for any Medicare Part B services and supplies before Medicare begins to pay its share. If a doctor, health care provider or supplier does not accept assignment, the amount you pay may be higher. If you receive your Medicare coverage through a Medicare Advantage Health Plan, you may owe little to nothing depending on the plan you are signed up with and your benefits with the plan. Clinical laboratory tests are not part of the physical exam.
How Should I Prepare for this Exam?
When you attend your "Welcome to Medicare" appointment, you should bring the following items:
- Medical records, including immunizations (unless your doctor already has a copy)
- Family health history (learn as much as you can, this will help determine your risk factors)
- List of prescription and over-the-counter medications (how often you take them and the reason you take them)
Is There Anything Else I Should Know About the "Welcome to Medicare" Exam?
If you are at risk for Abdominal Aortic Aneurysms (AAA), you must get a referral for a screening ultrasound at your "Welcome to Medicare" physical exam. This is a vascular disease with life-threatening implications.
The ultrasound screening for abdominal aortic aneurysms is covered if:
- You get a referral for the AAA ultrasound screening at the "Welcome to Medicare" physical exam.
- You have never had an AAA ultrasound screening paid for by Medicare.
- You have at least one of the following risk factors:
- family history of abdominal aortic aneurysm
- male aged 65 to 75 who has smoked at least 100 cigarettes during your lifetime