Physical And Medicare Questions

[vic120]

I have a client just called me T65 06/01 just got annual physical (including Pap smear) and was told it's not covered by medicare.

I read so much conflicting info lately on this subject

I have been under the impression that you are supposed to have everything (all the tests)covered in the 1st year as a welcome to medicare Physical

Also, I had read that Pap smears were cover after that every 2 years

Also Does getting one done the year before medicare affect what and when something is covered?

 

[somarco]

Should be "no charge" if the doc takes assignment and ONLY does what is allowed (see link below).

See pg 6 regarding PAP screening.

https://www.cms.gov/Outreach-and-Ed...LN/MLNProducts/Downloads/MPS_QRI_IPPE001a.pdf

Also THIS concerning PAP

Medicare Part B (Medical Insurance) covers Pap tests and pelvic exams to check for cervical and vaginal cancers. As part of the pelvic exam, Medicare also covers a clinical breast exam to check for breast cancer. Medicare covers these screening tests once every 24 months. If you’re at high risk for cervical or vaginal cancer, or if you’re of child-bearing age and had an abnormal Pap test in the past 36 months, Medicare covers these screening tests once every 12 months.

Part B also covers Human Papillomavirus (HPV) tests (as part of a Pap test) once every 5 years if you’re age 30-65 without HPV symptoms.

You pay nothing for the lab Pap and the lab HPV with Pap test if your doctor or other qualified health care provider accepts assignment. You also pay nothing for the Pap test specimen collection, pelvic exam and breast exam if your doctor or other qualified health care provider accepts assignment.

Part B covers certain doctors' services, outpatient care, medical supplies, and preventive services.

Your doctor or other health care provider may recommend you get services more often than Medicare covers. Or, they may recommend services that Medicare doesn’t cover. If this happens, you may have to pay some or all of the costs. Ask questions so you understand why your doctor is recommending certain services and whether Medicare will pay for them.

[URL="https://www.medicare.gov/coverage/cervical-vaginal-cancer-screenings"]Cervical Cancer Screening Coverage[/URL]

 

[vic120]

Should be "no charge" if the doc takes assignment and ONLY does what is allowed (see link below).

See pg 6 regarding PAP screening.

https://www.cms.gov/Outreach-and-Ed...LN/MLNProducts/Downloads/MPS_QRI_IPPE001a.pdf

Also THIS concerning PAP

Medicare Part B (Medical Insurance) covers Pap tests and pelvic exams to check for cervical and vaginal cancers. As part of the pelvic exam, Medicare also covers a clinical breast exam to check for breast cancer. Medicare covers these screening tests once every 24 months. If you’re at high risk for cervical or vaginal cancer, or if you’re of child-bearing age and had an abnormal Pap test in the past 36 months, Medicare covers these screening tests once every 12 months.

Part B also covers Human Papillomavirus (HPV) tests (as part of a Pap test) once every 5 years if you’re age 30-65 without HPV symptoms.

You pay nothing for the lab Pap and the lab HPV with Pap test if your doctor or other qualified health care provider accepts assignment. You also pay nothing for the Pap test specimen collection, pelvic exam and breast exam if your doctor or other qualified health care provider accepts assignment.

Part B covers certain doctors' services, outpatient care, medical supplies, and preventive services.

Your doctor or other health care provider may recommend you get services more often than Medicare covers. Or, they may recommend services that Medicare doesn’t cover. If this happens, you may have to pay some or all of the costs. Ask questions so you understand why your doctor is recommending certain services and whether Medicare will pay for them.

Cervical Cancer Screening Coverage

This is Great Thank you

 

[somarco]

Google is your friend . . .

 

[mickeyma]

Medicare does not cover annual physicals. Tell your client next year to request a "Wellness" visit. That is covered.

 

[somarco]

This situation as described by @vic120 appears to be the Welcome to Medicare exam.
Your "Welcome to Medicare" preventive visit | Medicare