You'll learn what's included in your plan and how your plan pays for care. A virtual visit may not allow for the same exams as an in-person visit, but it is still a key part of preventive care. So now more than ever, our in-home and online visits can be convenient, safe options for extra help managing your care. But your coverage wont start until July 1. Annual Wellness Visit and Additional Annual Physical Coding - Wellcare Your Medicare Advantage Preventive Care Glossary | Aetna Members and their providers will need to consult the member's benefit plan to determine if there are any exclusions or other benefit limitations applicable to this service or supply. If your birthday is on the first of the month, your IEP begins . To begin, review the resources and services on this page to get the most from your benefits. If you plan on working past the age of 65, you also need to coordinate your workplace coverage with Medicare. Im turning 65 or just starting to explore Medicare, Learn more about how your Medicare plan can help you achieve your health and wellness goals, Your coverage starts 1 month after you sign up, Your coverage starts 2 months after you sign up, Your coverage starts 3 months after you sign up. You can manage your plan benefits anywhere, anytime with the Aetna Health app. Members should discuss any Clinical Policy Bulletin (CPB) related to their coverage or condition with their treating provider. But be sure you tell the doctors office you are making your Welcome to Medicare appointment when you set up your visit. If the patient is sent to another facility for the ECG, the order must read ECG as part of the Welcome to Medicare Physical, codes G0366G0368. Medicare has instructed that physicians must order the ECG in a manner that helps to prevent use of codes for ECGs not related to the initial preventive physical exam. Health benefits and health insurance plans contain exclusions and limitations. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Aetna handles premium payments through Payer Express, a trusted payment service. But your enrollment journey may not be over quite yet. For example, if you enroll during the first three months of your IEP, coverage begins the first day of the month you turn 65. Welcome to Aetna Medicare Your journey begins today. The conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that this service or supply is covered (i.e., will be paid for by Aetna) for a particular member. You pay nothing for the visit. Medicare coverage for the whole you body, mind and spirit, Discover coverage that takes a total approach to health, See how we help you get the right resources and care, Take full advantage of everything your plan offers you. This visit will help establish your baseline health, which can help catch health problems early. If you do not intend to leave Aetna Medicare, close this message. Aetna Medicare insurance is not to only be used when you're sick or injured. PDF Medicare Preventive Care Visit - Fact Sheet Bennett recommends meeting with a Medicare agent, who can help you fine-tune your choices. With your coverage finalized, youll want to set up a Welcome to Medicare visit with your doctor. The information you will be accessing is provided by another organization or vendor. 4. Read closely. Thats because Medicare is different from other health insurance youve had in the past. Our plan selection pages will be down for maintenance starting Friday, April 16, at 9 p.m. and returning by 1 p.m. Saturday, April 17. The date your Medicare coverage begins depends on when you sign up. Apply if you think you might qualify. Along with settling on a new routine for the Welcome to Medicare exam, youll also want to make sure you understand its billing requirements. Starting to think about Medicare? The family history is performed to identify hereditary diseases or diseases that otherwise place the patient at increased risk for disease. Welcome to Medicare Visit (Initial Preventive Physical Exam (IPPE)) G0402 G0403-G0405 (IPPE w EKG) Once per lifetime . We're excited to show you how your plan can be a valuable support for your overall health. 9 months before your 65th birthday. The Appointment of Representative form is on CMS.gov. Aetna expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error. Medicare coverage for the whole you body, mind and spirit, Discover coverage that takes a total approach to health, See how we help you get the right resources and care, Take full advantage of everything your plan offers you. No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. In addition, some of the services are covered only if medically indicated. You're eligible for a one-time "Welcome to Medicare" visit with a doctor within your first 12 months of having Medicare Part B. Includes PPO, HMO, HMO-POS medical plans with or without drugs. Register for your secure personalized member website today, Get started with care and support focused on you and your needs, Your plan may offer extra benefits to keep you healthy and save on costs, Locate discounts on health products and services, View plan documents and your personal benefit video. If you have a Medicare Advantage (Part C) or prescription drug plan (Part D), the private insurer who administers each plan will send you separate cards. The total cost youll need to shoulder will depend on several factors like: How often you go to the doctor and use other services, Whether your health needs require hospitalization. CPT only Copyright 2022 American Medical Association. For a more comprehensive list of preventive services covered by your plan refer to your EOC. You are leaving our Medicare website and going to our non-Medicare website. To view the form just select Continue. Were bringing you to our trusted partner to help process your payments. It can even happen virtually. The information contained on this website and the products outlined here may not reflect product design or product availability in Arizona. Aetna Inc. and its affiliated companies are not responsible or liable for the content, accuracy or privacy practices of linked sites, or for products or services described on these sites. Sometimes you just need a form. But MA plans have telehealth coverage for primary, urgent and mental health and some specialty care. Aetna Inc. and itsitsaffiliated companies are not responsible or liable for the content, accuracy or privacy practices of linked sites, or for products or services described on these sites. Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna). New Year, New Medicare Benefits, FPM, February 2005, page 15, Preventive services covered by Medicare Part B., https://www.medicare.gov/Pubs/pdf/10110.pdf. If you want to get fancy, you could design a similar form with a duplicate page two, allowing you to keep the original and give the carbon copy to the patient. Want to see options for a different location? Our personalized service doesnt replace your relationship with your primary care physician (PCP). The SilverSneakers benefit helps you achieve your fitness goals. The month-by-month Medicare checklist below helps take the guesswork out of preparing for your enrollment. If you are a member and have already registered for member area and forum access, you can log in by clicking here. Healthy Home Visit Program (In Person or Telehealth) - Aetna Medicare To speed the process along, you could use preprinted patient education materials to counsel your patient. A focused physical exam. Includes PPO, HMO, HMO-POS medical plans with or without drugs. For determining fall risk, I recommend following the American Geriatrics Societys (AGS) clinical guidelines. Learn more about your plan and benefits at a member seminar. But keep in mind that these aren't the only services available to you. Since Clinical Policy Bulletins (CPBs) can be highly technical and are designed to be used by our professional staff in making clinical determinations in connection with coverage decisions, members should review these Bulletins with their providers so they may fully understand our policies. If you do not intend to leave our site, close this message. Top 10 preventive care services | Aetna Pneumococcal, influenza and hepatitis B vaccines, Diabetes outpatient self-management training services, Medical nutritional therapy for individuals with diabetes or renal disease. Everything you need to know about our women's health programs and policies. CMS (NextGen), Aetna, BCBS, HTA, Humana, UHC: Within first 12 months of Medicare Part B Coverage A comprehensive physical exam. Im turning 65 or just starting to explore Medicare, A review of your medical and social history, Height, weight and blood pressure measurements, A review of your potential risk for depression, A written plan letting you know which screenings, shots and other preventive services you need, Certain screenings, flu and pneumococcal shots and referrals for other care, if needed, Youve had Medicare Part B for longer than 12 months, and, You havent had a Welcome to Medicare or annual wellness visit within the past 12 months. For example, your health history can determine your chances for chronic diseases that are more common as we age. Set up a Welcome to Medicare visit with your doctor. Your InstaMed log in may be different from your Caremark.com secure member site log in. Have questions? Call the number on your Aetna Medicare Advantage member ID card. Your annual wellness visit will also include: Education and counseling about other preventive services, including certain screenings and vaccines (such as a flu shot, shingles vaccine and other recommended preventive treatments). Aetna handles premium payments throughInstaMed, a trusted payment service. If you do not intend to leave Aetna Medicare, close this message. Treating providers are solely responsible for dental advice and treatment of members. You are now being directed to CVS Caremark site. If you do not intend to leave Aetna Medicare, close this message. Welcome to Medicare | Medicare The new Medicare exam includes seven elements, and they add up to a patient encounter that is as much of a conversation as it is a physical exam. How to Conduct a "Welcome to Medicare" Visit | AAFP If you dont sign up during this window, you have to wait until the General Enrollment Period. If you do not intend to leave our site, close this message. An ICD-10 Z code is the first diagnosis code to list for wellness exams to ensure that member financial responsibility is $0. You can also request to have a printed copy mailed to you. This site has its own log in. Knowing about these benefits can help keep your health on track. WELCOME TO MEDICARE G0402 | Medical Billing and Coding Forum - AAPC Others have four tiers, three tiers or two tiers. 1-3 months before your 65th birthday. Copyright 2023 American Academy of Family Physicians. If you or your spouse worked and paid Medicare taxes for 10 years or more, you will qualify. Sachi Fujimoriis a writer and editor based in Brooklyn who focuses on writing about science and health. Aetna Medicare Plan (PPO) 2023 Schedule of Cost Sharing 2 . Were bringing you to our trusted partner to help process your payments. Annual Wellness Visit Coverage - Medicare Enrollment in SilverScript depends on contract renewal. Call the 24/7 nurse line at 1-800-556-1555 (TTY: 711) to speak with a registered nurse. For the full list, see Preventive services covered by Medicare Part B.. While the Clinical Policy Bulletins (CPBs) are developed to assist in administering plan benefits, they do not constitute a description of plan benefits. No fee schedules, basic unit, relative values or related listings are included in CPT. Members and their providers will need to consult the member's benefit plan to determine if there are any exclusions or other benefit limitations applicable to this service or supply. Yes, I'm a memberNo, I'm looking for a plan. Only a physician or qualified non-physician practitioner (PA, NP, or certified clinical nurse Determine whether Original Medicare (Parts A and B) or a Medicare Advantage plan is right for you. Together, we'll find more ways to help keep you healthy and living the life you love. Aetna handles premium payments through InstaMed, a trusted payment service. Everyone who enrolls in Medicare receives a government-issued red, white and blue Medicare card. You should ask your provider if the other services are covered as part of your welcome visit. Our Member Services team is happy to help. If the patient is sent to another facility for the ECG . Research Medicare Advantage plans. PDF Aetna Medicare - NYC.gov The member's benefit plan determines coverage. If you qualify for a Special Enrollment Period (for example, your coverage from an employer ends), coverage begins the first day of the month after you enroll. Perform some of the screening before the face-to-face encounter. Effective, efficient use of the initial preventive physical exam requires physicians and non-physician providers to understand the specific components of the initial preventive physical exam. 10. For example, Original Medicare does not include routine vision, routine dental or routine hearing benefits. Certain circumstances, such as the size of your company, can impact when you need to enroll. If you do not intend to leave our site, close this message. Learn more about how your Medicare plan can help you achieve your health and wellness goals. But remember that Medicare doesnt cover everything. Your Initial Enrollment Period (IEP) is underway. Your guide to telehealth | Aetna By clicking on I Accept, I acknowledge and accept that: The Applied Behavior Analysis (ABA) Medical Necessity Guidehelps determine appropriate (medically necessary) levels and types of care for patients in need of evaluation and treatment for behavioral health conditions. Aetna handles premium payments through Payer Express, a trusted payment service. Preventive Visit Coverage - Medicare Navigating Your "Welcome to Medicare" Visit | SelectQuote If you sign up for Medicare during the IEP, you should receive your card within 30 days of being approved. The goal of this visit is for your provider to assess your health and prepare a plan for future care. If so, you can download the form you need to get reimbursed for qualifying costs. SilverSneakers is a registered trademark of Tivity Health, Inc. 2022 Tivity Health, Inc. All rights reserved. Preventive Visit Coverage Your Medicare Coverage "Welcome to Medicare" preventive visit "Welcome to Medicare" preventive visit Medicare Part B (Medical Insurance) covers a "Welcome to Medicare" preventive visit once within the first 12 months you have Part B. Medicare coverage for the whole you body, mind and spirit, Discover coverage that takes a total approach to health, See how we help you get the right resources and care, Take full advantage of everything your plan offers you. Applicable FARS/DFARS apply. The new Welcome to Medicare exam revolves around preventive health care, something family physicians have always incorporated into their practice. This site has its own log in. Your Initial Enrollment Period (IEP) is underway. Your journey begins today. The Resources For Living program helps you manage your needs or those of a loved one. Aetna makes no representations and accepts no liability with respect to the content of any external information cited or relied upon in the Clinical Policy Bulletins (CPBs). In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. Some subtypes have five tiers of coverage. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2) (June 1995) and/or subject to the restrictions of DFARS 227.7202-1(a) (June 1995) and DFARS 227.7202-3(a) (June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department of Defense Federal procurements. It may be different from your Aetna secure member site log in. License to use CPT for any use not authorized herein must be obtained through the American Medical Association, CPT Intellectual Property Services, 515 N. State Street, Chicago, Illinois 60610.