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Medicare wellness check

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https://sigforum.com/eve/forums/a/tpc/f/230601935/m/9510052064

August 24, 2019, 08:04 AM
henryaz
Medicare wellness check
 
Medicare offers a free "wellness check" once per year. Yesterday, we got a call from our clinic wanting to schedule the check. I've been on Medicare for 7 years and never got this call before. I got the check once, a few years back, and all they did was take your BP, temp, weight and talk a bit. Nothing more than what they do when you visit your physician normally.
 
I asked the caller if this was required by Medicare, and without actually saying it is, she made it sound like it is. I passed, and did some online research. It appears now that the wellness check includes the above, plus a highly invasive questionnaire, like do you have grab bars in your bath/shower, do you wear a helmet while riding a bike, drugs you are taking, and I strongly suspect there is a question on there somewhere about having guns in the house. I found it is absolutely not required by Medicare, despite the insistence of the caller. Pass on this sham.



When in doubt, mumble
August 24, 2019, 08:27 AM
Pipe Smoker
I get the Medicare wellness check every year. My GP does more. A prostate enlargement check. Blood work. A cognition check (e.g., subtract 7 from 85. Continue subtracting 7 down to a small number). Questions, such as do I have handrails in my shower, etc.



Serious about crackers
August 24, 2019, 09:18 AM
mcrimm
Timely topic. My wife and I have been retired for just over 4 years. Neither one of us have health issues but decided to schedule the wellness check for next Tuesday.

They don't need to ask about guns . . all Montanans have guns in their homes and cars. They know that.



I'm sorry if I hurt you feelings when I called you stupid - I thought you already knew - Unknown
...................................
When you have no future, you live in the past. " Sycamore Row" by John Grisham
August 24, 2019, 09:53 AM
229DAK
I start Medicare October 1st. Apparently you must be on Medicare for a full year before you can have the wellness check.


_________________________________________________________________________
“A man’s treatment of a dog is no indication of the man’s nature, but his treatment of a cat is. It is the crucial test. None but the humane treat a cat well.”
-- Mark Twain, 1902
August 24, 2019, 09:54 AM
229DAK
quote:
prostate enlargement check

Eek


_________________________________________________________________________
“A man’s treatment of a dog is no indication of the man’s nature, but his treatment of a cat is. It is the crucial test. None but the humane treat a cat well.”
-- Mark Twain, 1902
August 24, 2019, 12:03 PM
SR
Is this the same as an annual physical? If yes, seems like it would be a good idea.

It might be worth listening to the questions in case some are medically relevant. Just tell the person that's asking you'll only answer medically relevant questions.

Perhaps a member in the medical field can step in and explain why Medicare wants this done and whether the amount Medicare pays the doctor makes this sort of service significant to the practice.




Speak softly and carry a big stick loaded Sig
August 24, 2019, 12:33 PM
ZSMICHAEL
Medicare offers a free "wellness check" once per year. Yesterday, we got a call from our clinic wanting to schedule the check. I've been on Medicare for 7 years and never got this call before. I got the check once, a few years back, and all they did was take your BP, temp, weight and talk a bit. Nothing more than what they do when you visit your physician normally
^^^^^^^^^^^^^^^^
It is about the money and government control in healthcare. Often the physician works for a hospital. The hospital is paid extra money to perform these wellness checks. CMS, the agency that runs Medicare decides these sorts of things. The latest is payment for an "Alcohol misuse screening." A bureaucrat comes up with these sorts of things, not your physician.
August 24, 2019, 12:36 PM
Sigfest
I believe the wellness checks done at your home are done by a nurse. I’ve always refused when they call or don’t answer. They may ask questions regarding meds and overall health, but I believe they are there to snoop as well. Overall living conditions, smoking, alcohol use, weapons laying around, family dynamics, safety issues, medication compliance, etc. Depending on who shows up to do the interview, these issues can be interpreted a number of ways. I am leery of letting someone like this in who may have an agenda. But maybe I’m overly suspicious.
August 24, 2019, 01:42 PM
V-Tail
quote:
Originally posted by Sigfest:

I believe the wellness checks done at your home are done by a nurse.
My doc has never mentioned any of this stuff.

My wife had a physical recently, was asked some questions about things that were never discussed before.

She was asked about depression. When the doc started with definitions, my wife interrupted, reminding doc that my wife has Master's in (psychiatric) Social Work and is Licensed Clinical Social Worker. End of that part of discussion.

Doc asked if we wanted a "home visit." Wife responded, "Why in the world would we want that?" End of that part of discussion.

Moved on to real medical things, like scheduling mammogram etc. Even that got into a small "discussion." There are two big players in this area -- Orlando Health Care, and Advent Health. The lab that my wife has been going to for more than thirty years is run by Orlando Health, she sees no reason to change. The doc is affiliated with Advent and is pushing their lab. Looks like it's all about the $$$. I don't have that situation, as my doc is associated with Advent, as is the lab I use.



הרחפת שלי מלאה בצלופחים
August 24, 2019, 06:02 PM
shovelhead
My past Medicare supplement coverage included a yearly wellness check which I declined. The lady on the phone insisted that I needed one. She then started asking me questions which I declined to answer. Finally she went back to the wellness check.

I then said to her "Is this required to keep my coverage?" She then started some double talk bout how it was not required but was suggested. I said to her "I'll pass on this, my doctor has any and all the information that you need to know" and ended the call.

Since changing to a Medicare Advantage Plan this year so far no calls, see if my luck holds out for next year.


-------------------------------------——————
————————--Ignorance is a powerful tool if applied at the right time, even, usually, surpassing knowledge(E.J.Potter, A.K.A. The Michigan Madman)
August 24, 2019, 06:09 PM
ZSMICHAEL
quote:
Since changing to a Medicare Advantage Plan this year so far no calls, see if my luck holds out for next year.

^^^^^^^^^^^^^^^^
It may be that the MA plan is not paid extra to do this sort of thing.
August 24, 2019, 07:52 PM
cne32507
I have Cigna medicare advantage. They give me a $50 Amazon (or other) gift certificate to have the wellness check. Hell yes!
August 24, 2019, 08:13 PM
henryaz
 
I see my family physician at the same clinic yearly, for follow-up of a couple of medical issues. All of my vitals, medications, lab results, etc. are in my chart, and all of my lab work is done across the street at the hospital, which is on a unified computer system with the clinic.
 
The caller told me the wellness check is definitely not the same thing as a physical exam, not even close. It's not even a doctor who does it, at least here.
 
I also do annual followups with a urologist (prostatectomy 16 years ago) and dermatologist (annual skin check), both of which Medicare pays for.
 
The thing that made me suspicious was that the caller all but insisted it was required, without actually saying so definitively. My research into the issue revealed this push is new, and aggressive, and in most cases they try to make the patient believe it is required. It is not. For those folks who don't otherwise see a doctor regularly, it might be a good idea, to screen for typical age-related conditions which haven't revealed themselves yet. But the invasive questionnaire bothers me with .gov collecting information. I agree with ZSMICHAEL that "It is about the money and government control in healthcare."



When in doubt, mumble
August 24, 2019, 08:35 PM
rexles
Just did mine last week. I see a PA and he does the blood work, urine test, BP, weight, asks questions about health only. He knows I am a shooter and NRA Instructor and we talk guns.
Never any goofy questions asked.


NRA Life member
NRA Certified Instructor
"Our duty is to serve the mission, and if we're not doing that, then we have no right to call what we do service" Marcus Luttrell
August 24, 2019, 09:25 PM
m1009
The wellness check, or AWV, is not the same as a physical. All they do is ask you very invasive questions, and make you check off the answers. They do not touch you for this service. Be careful if you get this. Only allowed once a year, if you get it done even one day too soon, Medicare will say it’s your responsibility and you could get stuck with a $225 bill. I think it’s 11 months and one day, but most places wait a year to be safe.
I would not ever get this done, in my opinion. I know about this due to my line of work. Have seen the required forms and the charges that are denied for patient responsibility too. It’s not ‘free’ technically. And Medicare does not pay for a routine physical, where they actually check you out.
August 24, 2019, 09:31 PM
ZSMICHAEL
quote:
I have Cigna medicare advantage. They give me a $50 Amazon (or other) gift certificate to have the wellness check. Hell yes!


^^^^^^^^^
My guess is the Cigna plan is required by the government to meet certain metrics. Giving you a gift card is a drop in the bucket for what the government pays for collecting this information.
August 25, 2019, 08:50 AM
V-Tail
quote:
Originally posted by ZSMICHAEL:

My guess is the Cigna plan is required by the government to meet certain metrics. Giving you a gift card is a drop in the bucket for what the government pays for collecting this information.
Reading the post directly before yours, it appears that the insurer charges Medicare $225 for doing this, so it looks like they are giving the Medicare patient a 22% cut of the fee and retaining 78% for the weighty task of asking some intrusive questions.

Actually, I bet they are getting those $50 gift cards for less than $50, with volume discounts.



הרחפת שלי מלאה בצלופחים
August 25, 2019, 09:24 AM
Nickelsig229
I get the phone call once every two weeks.

I talked to my doctor, and apparently he gave me the exact same questionnaire at one of my visits this year and doesn't understand why medicare would want it again. Apparently medicare is pushing their doctors to do the questionnaire as part of their requirements, although its not specifically required. There was no gun questions, but a lot about obstacles in the house, ability to cook/clean/bathe and depression questions.

When my father answers the phone he doesn't fully comprehend what they are asking. He hears them say they need to do a wellness check "for your Insurance" and doesn't realize it's a third party and while they may work with the insurance, they are going to bill the insurance, and it's not a requirement nor truly free.

As soon as I hear their pitch I simply ask if they are Employees of Anthem blue cross or a third party. They get the hint pretty quick.




First In Last Out
August 26, 2019, 07:05 AM
Haveme1or2
The wellness check is for really elderly shut ins, imo.
But they push it almost to the point of spam ... I get calls all the time using distant numbers from all over the usa.
Must be good money in it for the companies that service the contracts.
August 26, 2019, 07:16 AM
festus haggen
At my last wellness check, I was asked if I have more than 5 drinks a day. I told her if I drank that much I'd be on the floor. Then she asked me to draw a clock showing 11:15. I drew a rectangle with 23:15 inside. She didn't like that and wanted an analog clock drawing. Big Grin



Golden lads and girls all must,
As chimney-sweepers, come to dust.