Medicare to provide well visits

Starting Jan. 1, Medicare beneficiaries will get something they've never had before -- an annual physical paid for by the government.

As part of health-care reform, older and disabled people can get yearly "well visits" and health screenings - mammograms, diabetes screenings, prostate exams, heart tests - with no out-of-pocket cost.

Health experts say many older people skip preventive medical exams because they can't afford the fees or co-pays.

 "There are some people who will pay because they're concerned about their health, and there are other people who would like to get the physical but can't afford" it, said Andy Haggard of the Central Ohio Area Agency on Aging.

"These tests can catch potential health problems before they become massive, chronic conditions that would cost 10 times more than covering a medical test."

This will be a big expense to the federal government in the short run, but the expectations are that it will reduce expensive medical costs down the road, such as costly hospital admissions, surgeries and dialysis.

With so many baby boomers about to age into the Medicare system, it's important to catch health problems early, said Antonia Carroll, director of the Franklin County Office on Aging.

"We're hoping this new part of the health-care law will help them continue down a healthy path as they continue into old age," she said.

Health reform also requires private health insurers to cover the costs of preventative exams - physicals, screenings - for their customers. This affects health plans renewed after Sept. 23, 2009.

The annual Medicare physical will include a health-risk assessment based on family medical history as well as an assessment for memory loss and other cognitive impairments. The visit also will include a list of all health-care providers and the medications they've prescribed, along with information about relevant diseases.

"It gives a little more hands-on medical care," said Carly Glick, spokeswoman for the Ohio Department of Insurance. "Every 12 months, they'll get a well visit with their physician; a free checkup every year."

Despite Medicare not paying for annual physicals or health screenings in the past, some doctors did them for patients anyway.

For example, if a patient went to a doctor to check on his or her diabetes, the physician also would give a physical, perform a health-risk assessment and maybe a prostate exam.

"I would do that even though I wasn't getting paid for it," said Dr. David Sharkis, a North Side primary-care physician. "I was doing it because it was good medicine, not because it was covered by Medicare."

He said he knows he's not the only doctor who's provided these services for patients who are on fixed incomes.

"I'd tell them, 'I want you to come in for a physical exam,' and they'll say, 'Medicare doesn't pay for physicals,'" Sharkis said.

"I told them, 'Don't worry about it.'

"Now, when a patient comes in, I'm doing a preventative health service and I'm billing for a health service."

shoholik@dispatch.com