How To Get Medicare To Cover A Regular Physical Exam

Medicare Part B covers a few specific Medicare Part B does cover an examination by your doctor

, plus related laboratory work, X-rays, and diagnostic testing, to investigate a particular health problem or complaint. And, like most people over 65, you probably have at least one or more minor physical complaints or problems about which, ordinarily, you wouldn't make a special trip to the doctor. On the other hand, if you had a general physical examination and your doctor asked you about any problems or complaints, you would likely mention these. The trick to getting Medicare to pay for a general physical exam is to make these minor complaints the subject of a doctor visit. This turns the doctor's investigation of these problems -- which can include a fairly broad examination plus laboratory or other diagnostic work -- into a Medicare-covered service, as long as the exam and diagnostics are reasonably related to the physical complaints you have reported.

1. Call your doctor's office to make an appointment. When the person scheduling the appointment asks the reason for your visit, mention the conditions or symptoms that are bothering you. Do not ask for a regular physical examination.

2. When you see your doctor at the visit, begin by explaining the problems or symptoms that have been bothering you.

3. During the visit, remind the doctor that you have not had a physical examination in a while (your medical records will tell the doctor exactly when) and ask if he could give you as broad an examination as possible related to the symptoms or complaints you have mentioned.

4. You might want to mention to the doctor your concern that the examination and testing should meet Medicare coverage requirements. Doctors are very experienced with Medicare coverage rules and know how to describe your examination and testing in a way that places it under the Medicare umbrella. But it's up to you to give your doctor the chance to do this by presenting the doctor with specific complaints rather than merely asking for a physical exam.

Medicare Coverage Of Physical Exams

Medicare Exam Coverage

by: Caring Editorial Team

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