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Lake Regional Shares Guidance on Annual Health Visits

Tuesday, November 30, 2021

Preventive care is important, and patients at Lake Regional Health System are encouraged to have an annual visit with their provider to assess their overall health. However, patients should verify with their insurance provider beforehand to determine what topics and exams will and will not be covered in this annual health visit.

“For most patients, ‘wellness visit’ and ‘annual physical’ sound like the same thing,” said Candace Malson, ANP, a family medicine provider at Lake Regional Clinic – Laurie. “But for Medicare, these two terms are not interchangeable. Medicare provides a free wellness visit, which focuses on helping patients prevent health problems. Medicare does not provide a free annual physical, which includes an overall exam to detect and treat problems.”

Under Medicare, the goal of a wellness visit is to develop or update a personalized prevention plan and to perform a health risk assessment. In addition to discussing potential health risks, the wellness visit can include:

  • A review of your medical and family history.
  • Developing or updating a list of current providers and prescriptions.
  • Height, weight, blood pressure, and other routine measurements.
  • Detection of any cognitive impairment.
  • Detection of any behavioral risks, including depression.
  • Personalized health advice.
  • A list of risk factors and treatment options for you.
  • A screening schedule, such as a checklist, for appropriate preventive services.
  • Advance care planning.

“Patients also need to know that any problem-oriented parts of their health visit, as well as any procedures, will not be covered in the Medicare wellness visit,” Malson said. “We understand you might want to discuss a health problem — for example, if you have developed acid reflux or want your provider to check a spot on your skin — but please know this care will generate an additional charge. We do not want anyone to be surprised.”

Within their first year of joining Medicare, patients are eligible for the one-time only “Welcome to Medicare” visit, which includes a review of their medical and social history related to their health and education and counseling about preventive services.

Patients with private insurance likely have a different set of rules on what an annual visit covers. Always check with your insurance provider before your appointment to determine which services are covered. Just as with Medicare, patients can address problem-oriented concerns, but there may be a separate charge, or a separate problem-oriented visit might need to be scheduled.

Lake Regional Health System provides comprehensive health care services to residents and visitors throughout the mid-Missouri region. The hospital is a Level II Stroke Center, Level II STEMI (heart attack) Center and Level III Trauma Center. Lake Regional also provides a wide range of specialties, including cancer care, heart care, orthopedics and women’s health. Plus, Lake Regional operates primary care clinics, Express Care clinics, rehab therapy clinics, programs for home health and hospice, and retail pharmacies. To learn more, visit lakeregional.com.