Wellcare CalViva Health Dual Align (HMO D-SNP): Annual Wellness or Physical Visit

There is no coinsurance, copayment, or deductible for the your Annual Wellness Visit

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Cost
$0
Prior Authorization Required
No
Provider Referral or Order Required
No

How To Receive

Details on how to apply

  1. Schedule an appointment with your loved one's primary care provider.

  2. Attend the appointment and complete the wellness check.

  3. Work with the provider to review and update the care plan.


IMPORTANT: If you’ve had Part B for longer than 12 months, you can get an annual wellness visit to develop or update a personalized prevention plan based on your current health and risk factors. Our plan will cover the annual wellness visit once each calendar year.


NOTE: Your first annual wellness visit can’t take place within 12 months of your Welcome to Medicare preventive visit. However, you don’t need to have had a Welcome to Medicare visit to be covered for annual wellness visits after you’ve had Part B for 12 months.

Availability
Annually
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What it is

The provider will request the completion of a questionnaire, called a “Health Risk Assessment,” as part of this visit. Answering these questions helps develop a personalized prevention plan for health and well-being, and to get the most out of your visits. The wellness visit may include:

The provider will also perform a cognitive assessment to look for signs of dementia, including Alzheimer’s disease. Signs of cognitive impairment include trouble remembering, learning new things, concentrating, managing finances, and making decisions about everyday life. If the provider thinks there is cognitive impairment, a separate visit to thoroughly review cognitive function and check for conditions like dementia, depression, anxiety, or delirium is covered (as is creating an associated care plan for those needs).

The annual wellness visit can identify any problem areas and detect abnormalities in the body or blood that need further assessment and treatment.  Yearly check-ups are essential to disease prevention and management by identifying what’s working and what’s not before major issues develop.

Annual wellness visits help to develop or update a personalized prevention and management plan (often called a “care plan”) based on current health and risk factors.  It is important to recognize that a lot can change, for better or worse, over the course of 12 months, and not all changes are obvious.  Changes in blood pressure, blood sugar, kidney function, hearing or vision, weight, pain, digestion, and many more, often don’t come with signs or symptoms, whether improving or worsening.

Annual wellness visits are also a good time to review all prescription and over-the-counter medications, especially to determine and discuss any potential drug-drug or food-drug interactions, any side effects, if the medications are working as they should, if any changes need to be made, and explore what’s called “deprescribing,” which is the planned process of reducing or stopping medications that may no longer be of benefit or may be causing harm.

*Note that the first annual wellness visit cannot take place within 12 months of the “Welcome to Medicare” preventive visit.

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