Medicare Users Beware of Annual Physical Exams

What happens to many people as they approach their senior years?

Some find that they are no longer wanted by their employers and find themselves laid off for reasons other than their age, when of course, age is the real reason. Why? For two reasons.

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Older employees usually are paid at higher rates. Secondly, the costs to employers for their health plans is often based upon claims made the prior year and face it, older people usually have more health issues and needs than younger employees. Hence, it is cheaper for employers to lay off older workers and hire younger workers to take their place.

Not only do these older workers lose their income, but they also lose their healthcare plans. Those who are 65, have no alternative but to rely on Medicare parts A & B for their sole insurance needs.

Then there are many other seniors who find that when they retire, they find out that they cannot afford to purchase private healthcare coverage, leaving them relying on Medicare parts A & B.

Just a quick personal note – many of us seniors have been paying into Medicare for 30-40 or more years and then when we apply for Medicare benefits, we find out that we still have to continue to pay a monthly fee to use what we’ve paid into for most of our working lives.

Anyway, back to Medicare parts A & B.

According to

Part B covers 2 types of services


  • Medically necessary services: Services or supplies that are needed to diagnose or treat your medical condition and that meet accepted standards of medical practice.


  • Preventive servicesHealth care to prevent illness (like the flu) or detect it at an early stage, when treatment is most likely to work best.



You pay nothing for most preventive services if you get the services from a health care provider who accepts assignment.  

Sounds good, doesn’t it?

Would you consider an annual physical as medically necessary and/or preventive? Considering that at our age, virtually everyone is telling us to have this, that and the other checked out regularly, one would think that this would be part of those annual physicals, but that’s not necessarily the case as reported:

“When Beverly Dunn called her new primary care doctor’s office last November to schedule an annual checkup, she assumed her Medicare coverage would pick up most of the tab.”

“The appointment seemed like a routine physical, and she was pleased that the doctor spent a lot of time with her.”

“Until she got the bill: $400.”

“Dunn, 69, called the doctor’s office assuming there was a billing error. But it was no mistake, she was told. Medicare does not cover an annual physical exam.”

“Dunn, of Austin, Texas, was tripped up by Medicare’s confusing coverage rules. Federal law prohibits the health care program from paying for annual physicals, and patients who get them may be on the hook for the entire amount. But beneficiaries pay nothing for an ‘annual wellness visit,’ which the program covers in full as a preventive service.”

If you are one of us who are relying on Medicare to cover you regular annual physical, consider yourself warned. Call the doctor’s office or Medicare first to see if you are covered or not before making that appointment. Otherwise, be prepared to get a big doctor bill like Beverly Dunn.


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