# Annual Wellness Visit



## skipdisk

Hi Everyone,

I just heard from a friend that Medicare is offering something called an "Annual Wellness Visit" (different from annual physical). During this visit, the doctor goes over your entire medical history, provides a long term medical plan and is free to patients! Seems quite good, almost too good. Curious if I should talk to my doctor about this.

Have you been through an annual wellness visit? How was it? Or if not, why not?

Ankit.


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## retiredtraveler

I go to doc every 3 months for checkup and have annual physical. I have no need for a 'wellness visit'. I'm not sure who would be using this service. Maybe someone who has not been going to a doc regularly?


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## twinkles

i have  had an annual  wellness  done i dont see any difference than a regular check up-- she has her head stuck in the computer and ask you a couple of questions--you still have to pay a co pay and off you go


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## Don M.

twinkles said:


> i have  had an annual  wellness  done i dont see any difference than a regular check up-- she has her head stuck in the computer and ask you a couple of questions--you still have to pay a co pay and off you go



Same here...we go in for the "free" wellness visit every year, and it's not much more than a conversation while the doctor pecks on the computer.  I guess it has some value if a person mentions any new symptoms, and the doctor is paying attention.


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## terry123

I had one a few years ago and the doctor could barely speak English.  When they called the next time I said no thanks as I have my own doctor and I see him every few months.  They have not called again.


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## skipdisk

That's odd. I read online and looks like there shouldn't be any co insurance or Co pay.


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## Butterfly

I think these are worthless, especially if you have your own doc whom you see at last once a year.  I don't like everybody and their brother asking me medical questions -- that stuff is between me and my doc.


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## skipdisk

Thanks a lot folks. I haven't been to my doctor in maybe 6-7 months. So I might ask him what the deal is with this annual wellness visit next time I go. I definitely don't want to pay anything extra for it though.


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## Smiling Jane

Butterfly said:


> I think these are worthless, especially if you have your own doc whom you see at last once a year.  I don't like everybody and their brother asking me medical questions -- that stuff is between me and my doc.



I only participated in one of these, and it was with my regular doc. She had a medical assistant in the room with her who rapid-fired questions about my medical history, all of which they already knew, or should have known. If they had put me on a conveyer belt that ran me through the room, it wouldn't have been any faster.

i considered the experience totally worthless and I refused to repeat it the following year.


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## terry123

skipdisk said:


> That's odd. I read online and looks like there shouldn't be any co insurance or Co pay.


No copay and I would not pay for it. Free should be free.


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## dpwspringer

Smiling Jane said:


> I only participated in one of these, and it was with my regular doc. She had a medical assistant in the room with her who rapid-fired questions about my medical history, all of which they already knew, or should have known. If they had put me on a conveyer belt that ran me through the room, it wouldn't have been any faster.
> 
> i considered the experience totally worthless and I refused to repeat it the following year.


That pretty much sums up my experience with it... something for the doc to bill Medicare for. It is not suppose to be that way but that seemed to be the way it was for me. They just "combined" it with my yearly physical visit. I think it is suppose to be used as an opportunity to just chat with your doc for a while about things that concern you so that you get a better idea of your health concerns.


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## Pappy

I guess I’m in the minority here, but the wife and I have them visit once a year, through United Healthcare, and they are very helpful. She, the doctor, helped me understand my heart problems a lot better than my heart doctor did. We look forward to their free visit and, we always get a nice gift. This year, it was a $25.00 Walmart gift card.


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## Happyflowerlady

We have Cigna Healthsprings Medicare Advantage, and they also sponsor the wellness visit every year for us. This year, we already received the letter about the checkup, and we were offered a $50 gift card for taking the exam. 
It is usually just a quick visit, where they check the vitals (like usual), and we filled out a several page inventory of past medical history, and then they have you draw a little clock face and set the time on it, remember some words, and stuff like that. 
The doctor signed the paper that we had the wellness exam, and we sent it back in to Cigna, and should be receiving the gift cards any day now. There was no co-pay for having the exam, and we really didn’t have any kind of a future plan discussed. 
It might be that only people who have an Advantage Plan are given the wellness visit, and people with regular Medicare don’t get the benefit maybe ?


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## retiredtraveler

> _It might be that only people who have an Advantage Plan are given the  wellness visit, and people with regular Medicare don’t get the benefit  maybe ? 				_



No. It's 'regular' Medicare.


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## Gary O'

Sounds like a free inspection by a mechanic looking to vacation in Cancun


*'better have that checked out' *leads to where I don't care to go


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## Lynk

I have had the wellness checkup and did not have to pay for it. My regular doctor , she just asked me several questions and then gave me a memory test which I managed to pass.


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## WhatInThe

I know people who's insurance sends out a nurse once a year which is nothing but a bunch of questions and ultra basic short physical like bp, heart/breathing check and quick exam for things like edema. Problem is when the nurse wants to come sometimes they already had a doctors visit that week. The nurses get pushy because they get paid per patient visited which turns the visit into a waste of time.


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## Butterfly

WhatInThe said:


> I know people who's insurance sends out a nurse once a year which is nothing but a bunch of questions and ultra basic short physical like bp, heart/breathing check and quick exam for things like edema. Problem is when the nurse wants to come sometimes they already had a doctors visit that week. The nurses get pushy because they get paid per patient visited which turns the visit into a waste of time.



I feel quite strongly that for anyone not suffering from an illness that requires home support those "nurse visit" things are an invasion of privacy, to say the least.  I do not need some insurance company's nurse coming in and telling me how to manage my life.  The "bunch of questions" are an invasion -- if the questions and answers are important I have already discussed then with my own health care provider.  He/she already has my history and a list of my meds and knows my health status.  If I need health care I will seek it from my provider.

I have refused to participate in those nurse visit things.  No offense to nurses, I would still not participate if the visitors were board certified physicians.  Just because I am an older person does not mean I am incompetent to manage my own health care.


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## Smiling Jane

I wouldn't mind the nurse visits if they were actually helpful; if, for instance, they were there to point out safety issues that could cause problems. I could see them providing information on how to manage meds so they are taken properly. 

That's not what they do, so I can't see any point in their intrusion.


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## Aputernut17

Yes, we both get one every year, and while we are not supposed to be charged the co-pay $15.00 visit charge I was and Dh was not, so he phoned and asked why? answer was because I go  blood drawn for testing, why? no idea not necessary, they said at the Wellness exam the Dr. is only supposed to ask 10 questions, then no charge. I don't know but it's all very sketchy, it was the same as any other 6 mos. visit I have.


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## Butterfly

I have a deep and abiding distrust of insurance companies (especially health insurance companies) in general and the very fact that these alleged "wellness visits" are a creation of the insurance companies (and not your treating providers) and therefore in my eyes set off red flags.  I find the idea of "we're from your insurance company and we're here to help you" laughable -- kind of like if the IRS showed up at your door to "help you."  IMHO, all the insurance companies want to do is find ways to deny benefits or reduce your coverage.

Did anyone see the coverage where the medical director of Aetna testified he never looked at patient records when deciding whether or not to cover or deny medical procedures for patients?  THAT'S how they are here to help you.


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## WhatInThe

Butterfly said:


> I have a deep and abiding distrust of insurance companies (especially health insurance companies) in general and the very fact that these alleged "wellness visits" are a creation of the insurance companies (and not your treating providers) and therefore in my eyes set off red flags.  I find the idea of "we're from your insurance company and we're here to help you" laughable -- kind of like if the IRS showed up at your door to "help you."  IMHO, all the insurance companies want to do is find ways to deny benefits or reduce your coverage.
> 
> Did anyone see the coverage where the medical director of Aetna testified he never looked at patient records when deciding whether or not to cover or deny medical procedures for patients?  THAT'S how they are here to help you.



Insurance companies are definitely not your friend. Nor are many of these medical industry visitors-it's a job pure and simple. I've literally seen the smile come off a face the second they think the patient is out of sight. I always heard if somebody is writing or recording information in any fashion it's important. It might seem like a conversation but it's not.  Point being the insurance company & medical people are fishing for information, they have a mission. The patient thinks they are having a conversation. One industry worker told me that as soon as the insurance company thinks the patient isn't following treatment with things like taking medication they will be considered non compliant and coverage/treatment will be dropped. Also if things get nasty one day as in a lawsuit all those questions and answers will be scoured by lawyers looking for a defense.


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## Don M.

One of the latest "actions" that seems to be occurring is receiving a "ColoRectal" screening kit in the mail...to be sent to some "lab".  I've been getting these, 2 or 3 times a year, for the past couple of years.  I finally sent in a sample last Summer, and they quickly responded that I had blood in my stool, and wanted to make an appointment with some "specialist".  I wasn't noticing any problems, so a couple of months later, during my annual Wellness visit, I had my doctor send in a sample to His lab...the results came back OK.  These "Mail" offers, or the "As Seen on TV Cologuard" screenings, are...IMO...just another way to bleed our health care system, and pad the pockets of some unscrupulous individuals.


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## Butterfly

WhatInThe said:


> Insurance companies are definitely not your friend. Nor are many of these medical industry visitors-it's a job pure and simple. I've literally seen the smile come off a face the second they think the patient is out of sight. I always heard if somebody is writing or recording information in any fashion it's important. It might seem like a conversation but it's not.  Point being the insurance company & medical people are fishing for information, they have a mission. The patient thinks they are having a conversation. One industry worker told me that as soon as the insurance company thinks the patient isn't following treatment with things like taking medication they will be considered non compliant and coverage/treatment will be dropped. Also if things get nasty one day as in a lawsuit all those questions and answers will be scoured by lawyers looking for a defense.



Absolutely!


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## Capt Lightning

Here in the UK we get invited for an annual 'review' which usually consists of a nurse asking a st of pre-determined questions.
We are basically reduced to a set of parameters established by some faceless committee and if we don't give the 'right' answer, the nurse gets flustered....   A typical case.....  
"Do you drink ?"
"Yes"
"Now many units a week"
"Don't know.  I don't count"
"Can you give me an estimate?"
"What sort of number do you have in mind?"
"It's recommended that you don't drink more than 14 units a week"
"OK, 30"
"That's far too much, you should cut down"
"OK, 5"
"But you said 30"
"No, I said that I didn't count. I've got no idea,  why can't you accept that?"
"(Sigh) I'll say 14"

And so it goes on.  Total waste of time.

Occasionally a private health provider invites you to pay for tests that your GP does for free.  Maybe they think you'll be happier with their results.


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## NancyNGA

My doctor has never done the Wellness Visit, as far as I know.  I keep getting emails from SSA saying I still haven't used it.  :shrug:


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## Linda

My husband did it so he could get the $50 gift card.  It was just another way for the insurance company to rip off Medicare in my opinion.  The doctor didn't ask one question she didn't already have the answer too.  

They have a new thing now, called Chronic something or another, I forget.  Anyway, its a new deal where they can charge Medicare to do nothing that your primary care doctor should already have done.  My husband is saying no and refusing to sign their paper.  He said they plan to give me one to sign the next time I go in.  I have high blood pressure that I manage so well, the medical assistant told me she wished her blood pressure was as good as mine.  She said the same thing when I took the bone density test.

I say no to anything they offer me.  My husband and I are both getting pretty tired of going to the doctor and seeing nothing but her butt on a stool in front of her computer as she fires off comments and questions she already knows the answer to.  

But if any of this makes you feel more comfortable you should do it.  We especially dislike the part of the program where they want to call you regularly and remind you to take your pills and ask if you've gotten any exercise or eating properly.  I told one lady on the phone when she called to try and get me to sign up that we have children and adult grandchildren breathing down our necks and we don't need anyone else keeping an eye on us.  BUT if you are alone in the world and feel you need that contact, I'd say go for it.


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## WhatInThe

The gift card, yup. Don't know how many healthy already seeing doctors fall for that. But home health care or more 'casual' visits are the future. PAs and nurses are the future with many plans and/or in many areas.


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## Robusta

I see my GP every 8 weeks as I am diabetic.  Once a year I get a complete physical, this might be the "Wellness visit" you guys are referring to.   A much more thorough going over and in depth interview.
I have had the same doctor for 35 years. I met him while he was still interning and went with him when he opened his practice. He is Chinese and in all these years his English hasn't really improved.
Any way..... 
There we were, he on his stool, me on the bench.  He is looking through my chart,  "Ooh, You no have digital long time, turn aroun", my day went to hell in a single thrust!


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## Butterfly

WhatInThe said:


> The gift card, yup. Don't know how many healthy already seeing doctors fall for that. But home health care or more 'casual' visits are the future. PAs and nurses are the future with many plans and/or in many areas.



I see a PA rather than an MD at my health practice.  She actually listens better and seems to care more than any MD I've seen in a long time (except for my orthopedic surgeon, who is, surprisingly enough, quite empathetic and has a wonderful bedside manner).  I don't have any problem seeing a PA for routine stuff -- you don't really need an MD to check your blood pressure, listen to heart and lungs, review routine tests, etc., and treat minor stuff.  

HOWEVER, having said all that, I DO have a major problem with the insurance company trying to take over patient management -- that's a whole different colored horse, as insurance company representatives have the interests of the insurance company at heart, NOT the patient's.


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## Butterfly

Robusta said:


> I see my GP every 8 weeks as I am diabetic.  Once a year I get a complete physical, this might be the "Wellness visit" you guys are referring to.   A much more thorough going over and in depth interview.
> I have had the same doctor for 35 years. I met him while he was still interning and went with him when he opened his practice. He is Chinese and in all these years his English hasn't really improved.
> Any way.....
> There we were, he on his stool, me on the bench.  He is looking through my chart,  "Ooh, You no have digital long time, turn aroun", my day went to hell in a single thrust!



If you are getting this annual physical from your doctor, it is not the "wellness visit."


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## James

I have a family doc that I see once a year or every couple of years for routine stuff.  She is so busy it takes a month to get an appointment.  Besides that I have ongoing yearly cancer follow ups with two separate specialists and if there was anything "urgent"I would end up at an Urgent Care Office or Emerg.  My family doc is pretty much out of the loop as I trust myself more than her to manage my healthcare.

Our Village only has three doctors so you're pretty limited when it comes to choices.


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## Iodine

It sounds like a lot of us seniors are in the same bowl of soup.


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## jnos

Contrary to most of you, my husband and I appreciate the Medicare annual wellness visits. We see an FNP (Family Nurse Practitioner) at a local Community Health Clinic. Before we were eligible for Medicare, we had an employer plan with Blue Cross at this clinic. The Clinic has been our "regular doctor" for years. The only change with Medicare is that our annual physical, screening, etc. is all part of the annual wellness visit. 

I've been told the Annual Wellness Visit is intended for seniors who don't see a doctor until it's an emergency. With a physical, screening and tests, the doctor has a baseline to look back at each year. Having a comparison year to year is helpful. 

Funny side note on the memory screening at my first wellness visit. The very next day after I'd seen the doctor, we watched a movie where the woman was administered the screening test--exactly the one I was given.  It would have been even funnier if I had seen the movie first so I would have known the answers before she could ask them.


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## needshave

_I have had the annual wellness exam. I asked my doctor during a normal visit what exactly that meant or was. His response, its basically a conversation, not an exam. Medicare pays for it. (nothings free) I agreed to do it, as it turned out he asked about your parent's health history, alive or deceased, brothers /sisters and your kids. Looks at height and weight, wants you to draw the time he gives you on a piece of paper. that's it. Since I have no copay I did it. probably wont do it again, never would if I had a copay._


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## Linda

I refused mine after I saw the questions they asked last year.  I felt the primary care doctor should have been on top of all that anyway.  So in yesterdays mail I got it only on a couple sheets of paper.  I decided to be a sweet heart and go ahead and fill it out and mail it to them.  But I'm not going to do it in the doctor's office again.


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## needshave

I agree Linda. I know that my family doctor and I have discussed all that many times. It's been said before, but  "It's just a paycheck for the Doctor!"


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## Butterfly

needshave said:


> _I have had the annual wellness exam. I asked my doctor during a normal visit what exactly that meant or was. His response, its basically a conversation, not an exam. Medicare pays for it. (nothings free) I agreed to do it, as it turned out he asked about your parent's health history, alive or deceased, brothers /sisters and your kids. Looks at height and weight, wants you to draw the time he gives you on a piece of paper. that's it. Since I have no copay I did it. probably wont do it again, never would if I had a copay._



To me, it's a waste of everybody's time.  My parents' (deceased) health history is part of my record there, if they'd bother to look it up, and any concerns I have are addressed at my annual checkup or if something comes up in the interim.  And I certainly have no intention of hashing all this stuff over with someone who is not my PCP.


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## Smiling Jane

Butterfly said:


> To me, it's a waste of everybody's time.  My parents' (deceased) health history is part of my record there, if they'd bother to look it up, and any concerns I have are addressed at my annual checkup or if something comes up in the interim.  And I certainly have no intention of hashing all this stuff over with someone who is not my PCP.



That's my take on it too. My parents' health history (along with my siblings) has nothing to do with my health. There's no helpful genetic information to be culled, so why waste my time?


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## James

Smiling Jane said:


> That's my take on it too. My parents' health history (along with my siblings) has nothing to do with my health. There's no helpful genetic information to be culled, so why waste my time?



The health history of first, second and depending on the types of diseases, third degree relatives plays a big part in your overall healthcare.  It gives physicians an idea of what diseases you may be prone to and what they should watch as part of a surveillance plan.

For example my brother, first degree relative, was diagnosed at age 40 with bowel cancer.  I was immediately checked and had it as well although it was stage 2 and not 4.

My mother had uterine and kidney cancer in her 70's so my brother and I got checked for Kidney and Bladder Cancer.  My brother was good, me not so lucky {or I guess I could rephrase that as lucky it was found early}

So yes, family history is extremely important in your healthcare plan.  It saved me from an early grave.


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## WhatInThe

*environment and circumstance*

One of the things with family history is that is it genes or a common environment and/or tradition like cooking recipes, diet, smoking, smoke etc. I know people who painted their house/living areas every year right before xmas leaving people open to fumes, toxins etc. Some neighborhoods had issues with radon in basements & concrete. They used to treat wood with arsenic so if a family is in the same age neighborhood/house for any length of time that could be a factor. Pollution controls really didn't come into play until the mid to late 60s meaning if a child was exposed to many of the toxins no longer around or in large quantities that could be a factor as well.

I will say I've seen moms and grand moms pass at similar ages but yet sisters in the same family pass at completely different ages. I think environment could trigger a predisposition to a disease. It could be why it seems to skip many in the family because the right combination of environment, genes and experiences is not the same for everyone.


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## Butterfly

James said:


> The health history of first, second and depending on the types of diseases, third degree relatives plays a big part in your overall healthcare.  It gives physicians an idea of what diseases you may be prone to and what they should watch as part of a surveillance plan.
> 
> For example my brother, first degree relative, was diagnosed at age 40 with bowel cancer.  I was immediately checked and had it as well although it was stage 2 and not 4.
> 
> My mother had uterine and kidney cancer in her 70's so my brother and I got checked for Kidney and Bladder Cancer.  My brother was good, me not so lucky {or I guess I could rephrase that as lucky it was found early}
> 
> So yes, family history is extremely important in your healthcare plan.  It saved me from an early grave.



I never meant to say it was not important.  My point is, it is already in my records at my doctor's office.  So why do I need to go through all that again?  My parents and grandparents are still dead, and their causes of death and other history have not changed.  My sister is still alive and goes to the same practice I do, and everybody knows we are sisters.  So, what's the point in spending time writing down all that when they already have it?  Big boondoggle, IMHO.


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## James

Yep.  Understood, just replying to Smiling Jane's post.  Some information no matter how inconsequential one might think it is just might wave some red flags


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## dpwspringer

Butterfly said:


> I never meant to say it was not important.  My point is, it is already in my records at my doctor's office.  So why do I need to go through all that again?  My parents and grandparents are still dead, and their causes of death and other history have not changed.  My sister is still alive and goes to the same practice I do, and everybody knows we are sisters.  So, what's the point in spending time writing down all that when they already have it?  Big boondoggle, IMHO.


Not only that but the last one I supposedly had, it was an intern asking and then entering "their" interpretation of my answers, followed by similar questions from a nurse, and then a follow up from the doctor where he discussed with me what he chose to from what they had entered into the computer. I was wore out, frustrated, and did not feel like I got what I had hoped to from the visit, and I didn't get to discuss all the things I wanted to with the doctor that I wanted to after being grilled a couple of times by others... geesh that ain't the way to do things.


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## Butterfly

dpwspringer said:


> Not only that but the last one I supposedly had, it was an intern asking and then entering "their" interpretation of my answers, followed by similar questions from a nurse, and then a follow up from the doctor where he discussed with me what he chose to from what they had entered into the computer. I was wore out, frustrated, and did not feel like I got what I had hoped to from the visit, and I didn't get to discuss all the things I wanted to with the doctor that I wanted to after being grilled a couple of times by others... geesh that ain't the way to do things.



My friend went to one of those and she said she found the whole thing intrusive, offensive and insulting and felt like they were trying to catch her at something or decide she wasn't bright enough or together enough to take care of herself.  She came back close to tears.  

I had a similar experience right after I had my hips replaced, when a bright young thing physical therapist insisted on talking over my head to my daughter-in-law (who had dropped by to visit me) about whether I knew how to take my medications correctly and whether I was having any problems, etc.  I assured that PT that I was right there in the room, and was quite competent to take care of myself and to address her questions to me and not to a visitor in my home.  I also told her not to come back.  I am simply not going to tolerate that kind of treatment from medical professionals -- I may be older, but I will not be treated like a child just because I have grey hair.


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## WhatInThe

Butterfly said:


> My friend went to one of those and she said she found the whole thing intrusive, offensive and insulting and felt like they were trying to catch her at something or decide she wasn't bright enough or together enough to take care of herself.  She came back close to tears.
> 
> I had a similar experience right after I had my hips replaced, when a bright young thing physical therapist insisted on talking over my head to my daughter-in-law (who had dropped by to visit me) about whether I knew how to take my medications correctly and whether I was having any problems, etc.  I assured that PT that I was right there in the room, and was quite competent to take care of myself and to address her questions to me and not to a visitor in my home.  I also told her not to come back.  I am simply not going to tolerate that kind of treatment from medical professionals -- I may be older, but I will not be treated like a child just because I have grey hair.



I've seen that. Some patients need a second person others don't but it should be obvious if a patient is doing their part of not. It's another example of cya medicine except it's in the patient's home. Also it shows how many robots are in the health care industry.

Also in the office or home many of those questions are part of another test, it's not just about the answer but how you answered, we're you cooperative or combative. Also if a patient is considered non compliant insurance companies can stop or limit treatment. And in the home I guarantee you most visiting workers are told to look at conditions which is good and bad.

 From what I've seen only a handful are conscientious. Around here hospitals of reduced or eliminated alot of nursing services so there are alot of clock punchers just looking for a paycheck-some I hate to say are in no shape to be driving around, getting in and out of vehicles or deal with various road & physical conditions in home including heavier patients let alone 'nurse' a patient.


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## twinkles

i have the same problem as butterfly--i take my daughter with me to the ent dr and the vascular dr--they talk to my daughter(who is sitting across the room) i am hard of hearing  but they could stand aside of me-i am paying for this and i have to get all my information from my daughter.


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## rgp

twinkles said:


> i have the same problem as butterfly--i take my daughter with me to the ent dr and the vascular dr--they talk to my daughter(who is sitting across the room) i am hard of hearing  but they could stand aside of me-i am paying for this and i have to get all my information from my daughter.




   Can I be the devil's advocate ?

 Problem?..at least you have a daughter that goes with you. There are those that will not be bothered. There is a whole thread on that.

 And perhaps the doc , is trying to explain it to the person, younger person, with the better hearing & comprehension . And that knows best how to explain it to you? Perhaps later at home, in the less stress environment, over a nice cup'o tea/coffee.


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## Butterfly

rgp said:


> Can I be the devil's advocate ?
> 
> Problem?..at least you have a daughter that goes with you. There are those that will not be bothered. There is a whole thread on that.
> 
> And perhaps the doc , is trying to explain it to the person, younger person, with the better hearing & comprehension . And that knows best how to explain it to you? Perhaps later at home, in the less stress environment, over a nice cup'o tea/coffee.



Perhaps so, but I seriously resent the assumption that the younger person has "better hearing and comprehension" than the older person, and that the older person needs someone to interpret the doctor's instructions.  Just because a person has grey hair does not mean they do not have all their marbles and/or needs to be talked down to.


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## rgp

Butterfly said:


> Perhaps so, but I seriously resent the assumption that the younger person has "better hearing and comprehension" than the older person, and that the older person needs someone to interpret the doctor's instructions.  Just because a person has grey hair does not mean they do not have all their marbles and/or needs to be talked down to.




 Not my implication at all, My apologies if I have offended. 

 But let's be honest...quite often it is the case, and many of us live in denial of it. The doc is a professional , looking at it from the outside . And very possible he sees something you have not yet come to terms with. 

If I may suggest?...explain your view to both of them, perhaps they didn't realize, and in the meantime be thankful you have a caring daughter.

Again, my apologies if I'm out of line.


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## Colleen

Just my 2 cents worth on these "Wellness Exams"......I may have posted my experience on her in another column, and if so, I apologize for the repeat.

I was scheduled to have my exam in Feb. and when a women I did not know called me to schedule this, she said it was not at my doctor's office...it was at an Urgent Care! I thought there might be a separate entrance to this room but when I got there, I had to go through the waiting room to register. It was packed with people with the flu! To make a long story short, I left and did not get my exam. I was furious that my doctor would send me to such a place. I contacted my insurance (Humana) and asked if it was their "rule" for the exam to be done there and they said that every doctor makes his own decision where and how these are to be done. They asked me if I wanted to file a complaint and I said I did. That was the last straw with our doctor. There have been other things that have been happening and we felt a change was needed to get better medical care. These Wellness exams are a rip, in my opinion and I will not schedule any more.


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## Don M.

Colleen said:


> Just my 2 cents worth on these "Wellness Exams"......I may have posted my experience on her in another column, and if so, I apologize for the repeat. These Wellness exams are a rip, in my opinion and I will not schedule any more.



We, too, have our Medicare Advantage with Humana, and have had good results with the exams.  Medicare authorizes a number of preventative exams, and our Humana plan is even better than basic Medicare.  For example, Medicare covers a cardiovascular exam every 5 years, but our plan covers it every year once you reach 70.  I went in a couple of weeks ago, at our local doctors office, and had the blood work, etc., and the results all came back ok...Blood sugar, Cholesterol, Triglycerides, etc.  Then, the plan covers an annual lung cancer screening every year up to age 77....I will be going for a Low Dose CT scan at the hospital cancer center in a couple of weeks, for that test.  I suppose a lot of it depends on your doctor, but we haven't had any problems getting our exams.


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## Colleen

Don M......I'm not saying anything negative about Humana. We've had them for a long time and they have been very good to call and ask questions, etc. No problems with coverage either.

What I'm saying is: our doctor has decided he's not doing the Wellness exams himself. He farms them out to a NP or just a nurse and sends you to an Urgent Care facility, where there's anything and everything going on with people in the waiting room. It was the height of the flu epidemic here and not one person in the waiting room was wearing a mask. I did register and waited about 10 minutes in another waiting room but then I left because I couldn't get past the unclean, germ-ridden place. I was never contacted by my doctor or anyone else as to why I didn't have this done.

Another example of why our doctor is not giving the care he should is: My husband was due for his annual exam last November so I called and made the appointment. I specifically told the receptionist that it was for his yearly Wellness exam. She scheduled him for the doctor's office. When my husband went for his appointment, the doctor asked him what he was there for and my husband told him it was for his Wellness exam. The doctor said someone screwed up and he would only give my husband a short exam. He asked him a few questions and that was that....and charged Humana $309! The doctor didn't even check my husband for his enlarged prostate.

Obviously, our doctor is not doing his job. He use to be very conscientious but the last few times we've seen him he's been very lacks.


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## Don M.

Colleen said:


> Obviously, our doctor is not doing his job. He use to be very conscientious but the last few times we've seen him he's been very lacks.



I think you've found the root cause for your concerns....you might be better served by looking for another doctor.  Your doctor sound like he is using Medicare as his "cash cow".


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## Butterfly

The so-called "wellness visit" is NOT an annual physical.  It's a whole different thing altogether.


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## Don M.

Butterfly said:


> The so-called "wellness exam" is NOT an annual physical.  It's a whole different thing altogether.



That's right...the "wellness" visit/exam is an "opportunity" for a person to visit their PCP, and discuss any issues they may be concerned about...and then schedule any tests, etc., related to their concerns.  Medicare, and most health insurance plans cover a number of "screenings" at little, or no cost.  The Wellness visit is the first step to getting involved with these screenings.


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## Colleen

Don M. said:


> That's right...the "wellness" visit/exam is an "opportunity" for a person to visit their PCP, and discuss any issues they may be concerned about...and then schedule any tests, etc., related to their concerns.  Medicare, and most health insurance plans cover a number of "screenings" at little, or no cost.  The Wellness visit is the first step to getting involved with these screenings.



Exactly! We've both had our exams in the past and our PCP went over all medications, concerns, etc., and he did a prostate exam on my husband last year and that's when he found out it was enlarged. We're in the process of getting a new PCP and it's not easy because there just isn't quality doctor's where we live


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## Don M.

Colleen said:


> Exactly! We've both had our exams and our PCP went over all medications, concerns, etc., and he did a prostate exam on my husband last year and that's when he found out it was enlarged. We're in the process of getting a new PCP and it's not easy because there just isn't quality doctor's where we live



It's important to find a PCP that is interested in the patients health...rather than just "milking" Medicare.  There have been numerous reports in recent years about doctors in areas with a high concentration of retirees, such as Florida and Arizona...who just offer minimal care/concern to the patients, and rush them through so as to maximize their Medicare payments.  If a person feels they aren't getting the proper care, they should search for a better doctor, and in many cases, filing a Medicare Fraud report on the Medicare web-site, might well be in order.


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## Butterfly

Don M. said:


> That's right...the "wellness" visit/exam is an "opportunity" for a person to visit their PCP, and discuss any issues they may be concerned about...and then schedule any tests, etc., related to their concerns.  Medicare, and most health insurance plans cover a number of "screenings" at little, or no cost.  The Wellness visit is the first step to getting involved with these screenings.



I do all that at my annual checkup.


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## Don M.

Butterfly said:


> I do all that at my annual checkup.



If you are over 65, and on Medicare, an "annual" checkup, and an annual Medicare "wellness" visit are virtually the same.  

https://www.caring.com/questions/what-is-the-difference-physical-and-medicare-wellness-exam


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## Geezerette

I just got a call a few weeks ago to sched this Wellness" through my MED. adv plan. So this nurse practitioner who I've never met before never knew me all before, wants to go all over my records, of which I have many for the last couple of years, tell me how I'm doing & what to do next, for about 45 min then the primary care doc will come in for about 5-10 minutes. If it's only a $5 copay I might go for the entertainment, but not if it's more. Rolling eyes here. This health plan tries something new every few yrs. a Their last thing was the "Nurse Navigator" who was supposed to guide people around the system, but turned out I knew more about programs $ services than she did.


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## Colleen

Exactly! My appointment (which I did not keep) would have been with a total stranger. My doctor was not involved at all and he certainly wasn't at the Urgent Care where my exam was to be done! I wonder what would have been billed to my insurance and how much. I understand they can bill any amount they want and will only get paid by Medicare what's "reasonable and customary", but to bill for $309 in my husband's case, and not even get an exam, is a disgrace.


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## Butterfly

Don M. said:


> If you are over 65, and on Medicare, an "annual" checkup, and an annual Medicare "wellness" visit are virtually the same.
> 
> https://www.caring.com/questions/what-is-the-difference-physical-and-medicare-wellness-exam



I beg to differ.  In my experience, they are nothing at all alike.  Th so-called "wellness" thing is something set up by the insurance carrier (NOT Medicare) as an excuse to send a big fat bill to Medicare for sitting there and asking a bunch of questions about your medical history, which they already have.  There is no physical part of the alleged wellness exam. It is a total ripoff and a waste of time.


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## Butterfly

Colleen said:


> Exactly! My appointment (which I did not keep) would have been with a total stranger. My doctor was not involved at all and he certainly wasn't at the Urgent Care where my exam was to be done! I wonder what would have been billed to my insurance and how much. I understand they can bill any amount they want and will only get paid by Medicare what's "reasonable and customary", but to bill for $309 in my husband's case, and not even get an exam, is a disgrace.



I agree.  It's a ripoff, pure and simple.


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## Butterfly

rgp said:


> Not my implication at all, My apologies if I have offended.
> 
> *But let's be honest...quite often it is the case, and many of us live in denial of it. The doc is a professional , looking at it from the outside . And very possible he sees something you have not yet come to terms with.
> *
> If I may suggest?...explain your view to both of them, perhaps they didn't realize, and in the meantime be thankful you have a caring daughter.
> 
> Again, my apologies if I'm out of line.



First off, it may be "often" the  case, but more often it is not.   Secondly, I am not in denial of anything.  I live alone and take quite competent care of myself, so much so that the doctor let me go home on my own two days after my hip surgery, confident that I would do fine, and I did.

Secondly, the person I was speaking of was not the doctor, but a physical therapist visiting at my home.  The other person involved was my daughter in law, there to visit.  The therapist had no idea who she was, or whether I wanted my medical issues shared with her.  The therapist just spoke to her over my head because she was a younger person.  She could have been a census taker or my cleaning lady or any random person.  

And yes, I shared my "view" with her, and then asked her to leave.  I then called my surgeon and explained my "view" to him.  He was horrified that the therapist had behaved that way and had, in fact, even breached my medical privilege by discussing my case with a, to her, random stranger.  He apologized and told me he would not use that provider again.

I refuse to be treated as a mental defective or second class citizen simply because I am older.  Older people are entitled to the same respect as any other patient, and should be dealt with directly just like any other patient until there is reason to believe they are not capable with dealing with their own affairs.


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## Colleen

"I refuse to be treated as a mental defective or second class citizen simply because I am older. Older people are entitled to the same respect as any other patient, and should be dealt with directly just like any other patient until there is reason to believe they are not capable with dealing with their own affairs."........

I applaud you and agree 100%! It's our bodies and if we don't speak up for what we want or don't want done with it, then the blame is on us.

Ever since this "Wellness" exam debacle, we've been going to look for another doctor. It's not easy where we live to find a "quality" doctor so we've been dragging our feet on making a change. Well, today motivated us and tomorrow when we go into town, we're stopping in at a doctor's office to get a "feel" for the place. I've worked in many doctor's offices and hospital settings, so I'm a good judge of how things are run by looking at the front reception area. Hopefully, there will be good vibes.

What pushed us over the edge today was my Rx's. Last week I called my doctor's number but never got to talk to anyone to tell them I needed a refill on a couple Rx's. The phone just rings and then it has a message to leave a message and someone will get back to you. I gave up after a couple calls and submitted my Rx number to our pharmacy and asked them to contact the doctor. Today my husband had to go to town so he stopped at the pharmacy to pick up Rx's (he had one, too) and the pharmacist told him that the doctor's office has never gotten back with them to give me new Rx's. Our pharmacist was quite disgusted about it and said he would contact them again. When my husband paid for his RX he told the girl we were getting a different doctor, and she said, "That's probably a good idea." We don't know what's changed with our doctor, but something is going on. Time for us to move on.


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## moviequeen1

This morning I went for my 1st Wellness appt at my primary doctor's office. I didn't see him,instead one of his PA's{physician assistant}. She was very nice, checking to see how I was feeling emotionally/physically. She took my blood pressure,ask me a couple of questions. I did ask her to ck how tall I was, because I have heard as one gets older, you begin to shrink. I was pleasantly surprised to know I'm still 5'11 inches tall.
I try to go see my doctor once a year,I have no problems by participating with this wellness appt. She did tell me I'll be getting a $20 Visa gift card in the mail Sue


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## oldmontana

skipdisk said:


> Hi Everyone,
> 
> I just heard from a friend that Medicare is offering something called an "Annual Wellness Visit" (different from annual physical). During this visit, the doctor goes over your entire medical history, provides a long term medical plan and is free to patients! Seems quite good, almost too good. Curious if I should talk to my doctor about this.
> 
> Have you been through an annual wellness visit? How was it? Or if not, why not?
> 
> 
> =========================================================
> 
> Yes we get one.
> 
> We have a Medicare Advantage plan with Blue Cross.   We get one free physical each year.. a good one with blood work.  BC also sends each of us a $25 gift certificate to a store of our choice.


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## AZ Jim

I get an annual reminder.  It's a totally FREE benefit for Medicare patients.  A good deal.


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## Butterfly

oldmontana said:


> skipdisk said:
> 
> 
> 
> Hi Everyone,
> 
> I just heard from a friend that Medicare is offering something called an "Annual Wellness Visit" (different from annual physical). During this visit, the doctor goes over your entire medical history, provides a long term medical plan and is free to patients! Seems quite good, almost too good. Curious if I should talk to my doctor about this.
> 
> Have you been through an annual wellness visit? How was it? Or if not, why not?
> 
> 
> =========================================================
> 
> Yes we get one.
> 
> We have a Medicare Advantage plan with Blue Cross.   We get one free physical each year.. a good one with blood work.  BC also sends each of us a $25 gift certificate to a store of our choice.
> 
> 
> 
> 
> An Medicare "annual wellness visit" is *NOT* an annual physical.  It is a different thing altogether, and is basically a review of your medical history -- that's all.
> 
> The following is from the Medicare website:
> 
> SUBSEQUENT AWV COMPONENTS: APPLIES FOR ALL SUBSEQUENT AWV
> 
> s AFTER A
> BENEFICIARY’S FIRST AWV
> Acquire Updated Beneficiary Information
> Action
> Elements
> Update HRA
> ●
> Collect self-reported information from the beneficiary
> You or the beneficiary can update the HRA before or during the AWV encounter; it
> should take no more than 20 minutes
> ●
> At a minimum, address the following topics:
> Demographic data
> Self-assessment of health status
> Psychosocial risks
> Behavioral risks
> ADLs, including but not limited to: dressing, bathing, and walking
> Instrumental ADLs, including but not limited to: shopping, housekeeping, managing
> own medications, and handling finances
> Update the list of current providers
> and suppliers
> Include current providers and suppliers regularly involved in providing medical care to
> the beneficiary
> Update the beneficiary’s
> medical/family history
> At a minimum, update and document the following:
> ●
> Medical events of the beneficiary’s parents, siblings, and children, including diseases
> that may be hereditary or place the beneficiary at increased risk
> ●
> Past medical and surgical history, including experiences with illnesses, hospital stays,
> operations, allergies, injuries, and treatments
> ●
> Use of, or exposure to, medications and supplements, including calcium and vitamins
> Page 7 of 17
> MLN Educational Tool
> The ABCs of the Annual Wellness Visit (AWV)
> ICN 905706 April 2017
> Begin Assessment
> Action
> Elements
> Assess
> Obtain the following measurements:
> ●
> Weight (or waist circumference, if appropriate) and blood pressure
> ●
> Other routine measurements as deemed appropriate based on medical and
> family history
> Detect any cognitive impairment
> the beneficiary may have
> Assess the beneficiary’s cognitive function by direct observation, with due consideration
> of information obtained via beneficiary reports and concerns raised by family members,
> friends, caretakers, or others
> Counsel Beneficiary
> Action
> Elements
> Update the written screening
> schedule for the beneficiary
> Base written screening schedule on:
> ●
> Age-appropriate preventive services Medicare covers
> ●
> Recommendations from the
> USPSTF
> and the
> ACIP
> ●
> The beneficiary’s HRA, health status and screening history, and age-appropriate
> preventive services covered by Medicare
> Update the list of risk factors and
> conditions for which primary,
> secondary, or tertiary interventions
> are recommended or underway for
> the beneficiary
> Include the following:
> ●
> Mental health conditions
> ●
> Risk factors or conditions identified
> ●
> Treatment options and their associated risks and benefits
> Page 8 of 17
> 
> 
> MLN Educational Tool
> The ABCs of the Annual Wellness Visit (AWV)
> ICN 905706 April 2017
> Action
> Elements
> Furnish personalized health advice
> to the beneficiary and a referral, as
> appropriate, to health education or
> preventive counseling services
> or programs
> Include referrals to educational and counseling services or programs aimed at:
> ●
> Community-based lifestyle interventions to reduce health risks and promote self-
> management and wellness, including:
> Fall prevention
> Nutrition
> Physical activity
> Tobacco-use cessation
> Weight loss
> Furnish,
> at the discretion of the
> beneficiary
> , advance care
> planning services
> Include discussion about:
> ●
> Future care decisions that may need to be made
> ●
> How the beneficiary can let others know about care preferences
> ●
> Explanation of advance directives, which may involve the completion of standard forms
> 
> I am sorry about the formatting.  The form did not copy well from the website.  ANYWAY, you can see that this is NOT an annual physical.
Click to expand...


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## Colleen

It's a waste of my time and just another way for doctor's to collect $$$$$ without having to do anything.


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## CarolfromTX

My wellness visit, which was not free, but which I have to do if I want my prescriptions renewed, involved a LOT of talking. And questions like "Do you feel safe at home?" and "Any falls recently?" She checked my gait, and asked a jillion more goofy questions, including '"Have you started smoking?" Um... no.  I get that it's a Medicare protocol, but hubby's doctor never asks him any of that stuff. And if one of us needs those questions, then it's him. Sigh.


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## oldmontana

Colleen said:


> It's a waste of my time and just another way for doctor's to collect $$$$$ without having to do anything.




----------------------------------------------------------------------------------------------------------

Have you ever considered going to another doctor instead of complaining about your doctor/clinic?


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## Colleen

oldmontana said:


> ----------------------------------------------------------------------------------------------------------
> 
> Have you ever considered going to another doctor instead of complaining about your doctor/clinic?



That's a pretty rude comment! Have you read the whole thread?? FYI...we have changed doctor's....if that's any of your business!


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## peppermint

My wellness visit was free..   I'm sitting in the waiting room with a 2 page paper to answer questions....Unbelievable..  It asked how much alcohol in a day I drink?   (I hardly drink alcohol, except on a Holiday)
How many times in a year do you visit your Doctor....Am I depressed....Do you get angry most of the time...and on and on with stupid questions....

I finally get to go to the room for questioning....It was weird!!!!!   A nurse or whatever she was, started asking me questions....and drawing pictures....I had to draw a dog....a hamburger, and some other
stuff that I was really annoyed with....So after many questions, she asked me what she asked me 3 min. ago....I told her and she said it was wrong...So I said to her, Oh, maybe that was 2 min. ago...
She got perturbed....I didn't care, this was ridiculous thinking Seniors are senile...  She leaves....The Doctor came in the room...(I have been going to this lady Dr. for 40 years)...She asked why
I didn't answer the question that the nurse asked...I told her a thing or too, and she said she is obligated to ask these questions for Medicare....So I asked, Did I fail....She laughed!!!  She said No....
As long as you were talking and not slurring your words.....WHAT!!!!!!    Good thing I love my Doctor...She stayed with me for 10 min more, just talking about her husband who had passed away....


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## oldmontana

peppermint said:


> My wellness visit was free..   I'm sitting in the waiting room with a 2 page paper to answer questions....Unbelievable..  It asked how much alcohol in a day I drink?   (I hardly drink alcohol, except on a Holiday)
> How many times in a year do you visit your Doctor....Am I depressed....Do you get angry most of the time...and on and on with stupid questions....
> 
> I finally get to go to the room for questioning....It was weird!!!!!   A nurse or whatever she was, started asking me questions....and drawing pictures....I had to draw a dog....a hamburger, and some other
> stuff that I was really annoyed with....So after many questions, she asked me what she asked me 3 min. ago....I told her and she said it was wrong...So I said to her, Oh, maybe that was 2 min. ago...
> She got perturbed....I didn't care, this was ridiculous thinking Seniors are senile...  She leaves....The Doctor came in the room...(I have been going to this lady Dr. for 40 years)...She asked why
> I didn't answer the question that the nurse asked...I told her a thing or too, and she said she is obligated to ask these questions for Medicare....So I asked, Did I fail....She laughed!!!  She said No....
> As long as you were talking and not slurring your words.....WHAT!!!!!!    Good thing I love my Doctor...She stayed with me for 10 min more, just talking about her husband who had passed away....



------------------------------------------------------------------------------------------------------

Asking questions, etc like that is SOP for a annual physical for seniors...its a good why to check if one is senile.  I have no problem with it.


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## peppermint

If I get senile, I'll probably won't go to a Doctor....I would forget!!!  Kidding....It wasn't a problem it was a 2 hour wait for a silly quiz....


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## Pauline1954

skipdisk said:


> That's odd. I read online and looks like there shouldn't be any co insurance or Co pay.




Right, no copay UNLESS  here read the guidelines for it.

https://www.medicare.gov/coverage/welcome-to-medicare-preventive-visit


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## norman

My annual wellness was free, I did not answer questions that I felt were nunyas (none of your f_ _kin business.) The one that made me question the questionnaire was, "Do you have smoke detectors."  The nurse explained that these questions were to determine our general well being, mental health, etc.  The next time I will answer them all and not be defensive.  I had to pay for one extra test as I had a complete blood work-up which tells you everything you need to know about your heath.  If doctor finds anything when he reads the results they call you or you can read them onine if you are interested.


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## Butterfly

I don't do the so-called Medicare annual wellness visit.  I go have my annual checkup and that is all.  No intrusive questions -- and I wouldn't answer those questions others are talking about either.  Not my doc's business whether or not I have smoke detectors, etc.  I consider that kind of stuff to be "Big Brother" type intrusiveness into how I run my life and I refuse to participate.  As to drawing a dog or a hamburger, I couldn't draw worth a flip when I was 20, and I still can't -- what does that prove?


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## terry123

I do not have a copay and have never been asked about smoke detectors.  If I am asked I will say yes and do not see the big deal.  If I do not want to answer a question, I don't.  Some things are none of their business.


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## JustBonee

I had a wellness visit last year.  First time that I've done that.   The visiting nurse was a little unorganized with her schedule that day,  but she did convince me to get my eyes examined.  That visit led to laser surgery during the summer,  and for that I am grateful.  It helped with my AMD.  
No fees were charged to me,  and  I even got $100 in gift cards from Blue Cross for doing this.   

However, my doctor does not  approve of these wellness visits.  He let me know that their opinions aren't of any importance to him.  ???


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## Pauline1954

I went today. I feel my doctor did a good thing. No questions except have I had colonoscopy, when was the last mammogram, ask me about pneumonia shot, shingles shot.  Thats its.  I told her I dont want a colonoscopy. So she suggested a different test called colonguard test. I told her I am not sure about the shingles shot and told her I want to research it. I did ask ask her about my thyroid medication. And explained why getting 6 months supply saves me money and my insurance does not pay for it. So she wrote me a prescription for 6 months. Yay.  Im so happy. But the visit was pleasant and ive been seeing her since s
before she built her own building and opened her own  practice. 

Any feed back is appreciated on shingles, pneumonia shot and colonguard test.

Thank you


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## JustBonee

Pauline1954 said:


> Any feed back is appreciated on shingles, pneumonia shot and colonguard test.
> Thank you



There are two pneumonia vaccines for seniors,  Prevnar 13 and Pneumovax 23.  I've had both.  They are given about one year apart, and I would strongly recommend both of them.  They fight several types of bacteria that can affect seniors, and especially important if you go to a hospital or are around sickly people.

I cannot address the shingles shot or getting a colonguard test...  I had a routine colonoscopy some years back and it was just an inconvenience, nothing more.


----------

