I CONCLUDED LAST week’s column with “Medicare happens,” implying that we were finished, at least for the time being, with talking about Medicare.
I lied. I didn’t mean to lie, but I did.
Here’s why:
• Medicare does, in fact, happen.
In fact, it’s been happening for more than 50 years, in case any of you are inclined to burst into song.
And while Medicare can be a black hole of detail and nuance, the fact remains that it touches more and more of us every day.
• Upon reflection, it occurred to me that I should take the opportunity to attempt to explain a Medicare thing that seems to confuse a lot of us, so here goes:
The reason that this Medicare thing seems confusing is because it’s confusing.
Specifically, it’s about the “Welcome to Medicare Preventive Visit” vs. the yearly “Wellness” visit.
“Visit” means going to your doctor or your primary care provider.
The reason that I emphasized “preventive visit” is because this is often referred to as the “welcome to Medicare physical.”
It isn’t; it’s a “preventive visit.”
Now, things will happen that feel like a physical, such as you’ll have your height, weight, blood pressure and body mass index measured, but it should also include a simple vision test, a simple depression screening, a written plan for preventive services and more.
It is not uncommon for doctors (and/or office staff) to call this a “welcome to Medicare physical,” too.
I don’t care; neither do you, as long as they bill it correctly.
But you get to get this one time, and that’s within the first 12 months that you have Part B, and it won’t cost you anything (assuming your provider accepts Medicare assignment) nor will your Part B deductible apply.
That’s one thing.
Here’s the other thing: That being the yearly “wellness” visit.
Develop a plan
The idea here is to develop a personalized plan that should help prevent disease, disability and other unpleasant developments, based on who you are and what you do.
It should include things such as your height, weight and blood pressure being measured (see why these things get confused?) as well as medical/family history, updated lists of medical providers and prescriptions, a list of your risk factors, a screening schedule and more.
This won’t cost you anything (assuming your provider accepts Medicare assignment) nor will your Part B deductible apply.
You can get this every 12 months.
Confused yet? I get it.
One way to do this would be to go get your welcome to Medicare preventive visit” pretty soon after you go onto Part B, such as in the first three months or so. Then, count 11 months and schedule your annual “wellness” visit and live happily ever after.
Now, stop.
All that was about Medicare; this about us:
True, both of these visits are free.
Now, if in the course of either of these visits your doctor orders/recommends this or that additional test or whatnot, might that have a cost?
Yes, it might … or it might not.
If you really want to learn about the specifics of preventive services, go to http://tinyurl.com/PDN-PreventiveServices and have at it.
If you’re just inherently suspicious and want to see what I’m looking at, go to http://tinyurl.com/PDN-Visit-Exam and feel validated.
Here’s the good news about all this preventive stuff: It can often catch something bad on the front-end, so something can be done before the bad thing becomes a really bad thing.
The bad news?
Well, it might tell us things that we don’t want to hear and tell us to do things that we don’t want to do, such as stop doing the dumb thing that we know is dumb but don’t want to stop doing.
Can they make us stop doing the dumb thing?
Considerable guilt
No, but the guilt can be considerable, which is why some of us avoid preventive stuff.
Yeah, think about it.
The only way to actually reduce the level of interaction with Medicare is to use it as little as possible, which means being as healthy as possible.
A smart way to be as healthy as possible is to use the preventive benefits that Medicare pays for, so, yes, we are using Medicare to avoid Medicare (I know, but that’s how it is).
Now, stop again, and enough with all this Medicare stuff. This is about your life — how you want to feel, what you want to do and what’s important to you.
So we have to step out of all this health insurance stuff for a minute and think about that.
Then, based on what we know about us and the people we purport to love, make some decisions about what to do and how to do it.
Medicare is a means to an end, not an end in itself.
It’s just one of the ways that a lot of us have to get there from here.
Medicare happens. Life matters.
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Mark Harvey is director of Clallam/Jefferson Senior Information & Assistance, which operates through the Olympic Area Agency on Aging. He is also a member of the Community Advocates for Rural Elders partnership. He can be reached at 360-452-3221 (Port Angeles-Sequim), 360-385-2552 (Jefferson County) or 360-374-9496 (West End), or by emailing harvemb@dshs.wa.gov.
