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Does Medicare Cover Physicals & Blood Work?

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By Daniel Petkevich

Feb 1, 2024

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Patient & Doctor

Medicare Part B plays a pivotal role in covering outpatient services. Annual physicals and blood work typically fall under the umbrella of preventive services, and Medicare Part B is designed to cover these essential health checkups. Here are some distinctions to consider when scheduling your yearly doctor visit:

Medicare Wellness Visit

  • A preventive service offered by Medicare to beneficiaries.

  • It includes a review of your medical and family history, current health conditions, and a discussion of any risk factors.

  • The healthcare provider may perform measurements such as height, weight, blood pressure, and other routine assessments.

  • The primary goal is to develop or update a personalized prevention plan to help prevent disease and disability based on your current health and risk factors.

  • Medicare typically covers this visit annually.

Physical Exam

  • A physical exam is a broader examination of your overall health and is not considered a routine preventive service under Medicare.

  • It may involve a more comprehensive examination, including a head-to-toe assessment of your body systems.

  • Physical exams are often performed when experiencing specific symptoms or as part of a diagnostic evaluation.

  • While Medicare may cover certain aspects of a physical exam, it depends on the nature of the exam and the medical necessity. As a rule,  Medicare does not cover an annual physical. The exam and any tests your doctor orders are separate services, and you may have costs related to each depending on your Medicare plan.

Blood Work and Preventive Screenings

Medicare Part B also covers a range of preventive screenings, including blood tests. These screenings are vital for early detection of potential health issues and play a crucial role in maintaining overall well-being. Some common blood tests covered by Medicare include cholesterol screenings, diabetes screenings, and certain cancer screenings. However, Routine Bloodwork or CBC is not covered by Medicare.

Conclusion

It's important to note that coverage details can vary, and beneficiaries should check with their specific Medicare plan for the most accurate and up-to-date information. Additionally, discussions with healthcare providers about the specific services and their coverage under Medicare are crucial to understanding individual healthcare needs.

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