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How to Schedule a Wellness Exam Without a Primary Care Doctor

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Preventive care and examinations are becoming more than a trend in modern medicine. A wellness exam, also referred to as a preventive physical or health maintenance examination, can potentially spot problems sooner and may result in more effective treatments. However, not all individuals are set up with a primary care doctor or hospital network, which can make scheduling and affording these exams more challenging. If you're unsure about the benefits and costs of preventive care and how to schedule an exam, here are some helpful tips.

What Does a Wellness Exam Cover?

Health care professionals tend to recommend annual wellness exams, even if you don't notice any particular symptoms, to ensure you don't have risk factors or haven't developed signs for diseases that are easily treatable if detected early on. In recent years, however, health care professionals have debated whether the frequency of wellness exams should be tailored to suit the needs of the patient.

Depending on your age and gender, your annual wellness exam will focus on different factors and conditions. According to the American Academy of Family Physicians and the American Academy of Pediatrics, these are some of the most common evaluations that certain groups can expect:

For Adult Men

  • Blood pressure (diabetes mellitus)
  • Lipids (cardiovascular disease)
  • Prostate-specific antigens (prostate cancer)
  • Colonoscopy (colorectal cancer)
  • Risk factors for sexually transmitted diseases
  • Substance abuse
  • Symptoms of depression

For Adult Women

  • Blood pressure (diabetes mellitus)
  • Pap smear (cervical cancer)
  • Mammogram (breast cancer)
  • Colonoscopy (colorectal cancer)
  • Osteoporosis
  • Preconception counseling and contraception, as needed
  • Risk factors for sexually transmitted diseases
  • Substance abuse
  • Symptoms of depression
  • Intimate partner violence

For Children

  • Growth and developmental milestones
  • Immunizations
  • Nutrition and eating behaviors
  • Social behaviors
  • Safety
  • Learning
  • Sleep
  • Child and family's emotional well-being

Note: Depending on your age and the time since your last screening, you may not undergo all of these screenings at each annual wellness visit.

Where to Schedule a Wellness Exam

Most health care organizations and professionals recommend setting yourself up with a primary care doctor or hospital network to schedule well person exams. However, if you don't have access to either, there are a few other options.

  • Urgent care centers: Some urgent care centers can perform many, if not all, of these preventive screenings. Contact your local center to determine if their facilities are sufficient for your needs.
  • University health clinics/medical centers: If you attend a university, your school's health clinic may perform many of these screenings. Even if you're not enrolled, some universities and medical centers offer more affordable screenings performed by doctors-in-training.
  • Other local doctors: Many doctors, particularly general practitioners and internists, will perform these exams on first-time patients, even if you don't plan to follow up with the same doctor each year.
  • Telemedicine: Telemedicine is becoming increasingly common, especially for rural areas. You will likely have to visit designated testing sites for certain tests and screenings, but others can be performed through video chat with a qualified doctor who has the screening results in-hand.

What Medicare Covers

Based on parameters set by the Affordable Care Act, Medicare does cover an annual wellness visit (AWV), according to AARP. However, per the Centers for Medicare and Medicaid Services, individuals' yearly checkups are only eligible for Medicare coverage if they're not within the first 12 months of their first Medicare Part B coverage period and have not received an Initial Preventive Physical Examination (IPPE) or AWV within the past 12 months.

An individual's first annual wellness visit under Medicare requires a health risk assessment (HRA), which includes:

  • Self-assessment of your health status
  • Demographic data
  • Psychosocial risks
  • Behavioral risks
  • Daily activities
  • List of current health care providers and suppliers
  • Your medical and family history
  • Review of potential risk factors for depression and other mental disorders
  • Review of your functional ability and level of safety

After your first annual wellness visit, subsequent yearly appointments will primarily update information, when necessary, and assess any changes to your physical health, cognitive function, and mental or emotional health. Your doctor will also update your screenings schedule, risk factors, treatment options, and referrals, as needed.

Don't let the lack of a primary care doctor stop you from scheduling a regular wellness exam. Taking charge of your health and preventive care will lead to a healthier life.

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