Seniors on Medicare can now get priceless care for free

Marcus Pickett


For seniors, health care reform means a host of changes to Medicare in 2011. Among them is the establishment of annual wellness exams and other preventive services at no cost to the patient.

Here is a rundown of what seniors could be getting for free this year.

Wellness visit

From checking a senior's height, weight and vital signs to identifying the need for further screening and diagnostic tests, the wellness exam covers the essentials of any medical check-up.

Those who are already enrolled in Medicare or who are familiar with the program might wonder how the free annual wellness exam is different from the initial enrollment exam, also known as the "Welcome to Medicare" exam.

  • The new wellness visit is available each and every year. The "Welcome" exam is available only once, upon enrollment.
  • Primary care physicians get reimbursed more for the wellness exam, according to the Senior Citizen Journal, which could increase the rate of doctors who accept the assignment.
  • The wellness exam sets up a schedule for future preventive screenings and a long-term care plan, according to the American Academy of Family Physicians.
  • The exam looks for cognitive impairment, functional ability and depression.
  • Seniors pay nothing for the wellness exam, if the doctor accepts the assignment. The Welcome exam had subject to 20 percent co-pays; now, that exam is free as well.

Preparing for an annual wellness visit

According to, the three things seniors should bring to their wellness exam are:

  • Medical records, including immunization records.
  • Family health history. Try to learn as much as you can about your family's health history before your appointment. Any information you can give your doctor can help determine if you're at risk for certain diseases.
  • A list of prescription drugs that you currently take, how often you take them and why.

Preventive services

Starting in 2011, patients no longer will have to pay any out-of-pocket costs for several voluntary preventive services like screenings, measurements and vaccinations. The wellness exam should help identify which services are needed, although they are not part of the exam itself.

Some of the free preventive services available this year, according to, include:

  • Mammograms every 12 months.
  • Screenings for abdominal aortic aneurysms, HIV, cholesterol, diabetes and certain cancers.
  • Nutritional therapy for diabetes or kidney disease.
  • Annual flu shot and hepatitis B vaccine.
  • Bone mass measurement.

End-of-life planning, 'death panels' and advance directives

Originally, end-of-life planning was listed as one of the free services available to Medicare recipients during their wellness exams. Yet, within the first week of 2011, references to end-of-life planning were dropped from Medicare regulations.

The idea of providing for voluntary end-of-life counseling first appeared in the original health care reform legislation, but was abandoned after opponents raised concerns about "death panels." It reappeared in Medicare's new rules for 2011. Still, the concept of a government program encouraging end-of-life counseling and reimbursing doctors for it remains controversial.

Political controversies aside, it's important that seniors understand exactly what end-of-life counseling means for them in terms of their care and family finances. Although doctors may not be reimbursed by Medicare for discussions about end-of-life planning and advance directives, nothing is stopping seniors from asking about them. Doing so in advance often is better than waiting until the situation arises; in the midst of grief, it becomes increasingly difficult for patients and their loved ones to make tough decisions.

The most controversial part of end-of-life planning is the advance directive. According to, advance directives are "legal documents that allow you to put in writing what kind of health care you would want if you were too ill to speak for yourself." Advance directives are voluntary and can be modified anytime -- even with a verbal statement at the hospital. New York Online Access to Health (NOAH) provides a state-by-state list of advance directive guidelines.