Medicare & Women’s Health Services
We want you to feel informed and confident about the services you receive. Medicare may not cover all services during your annual visit. If coverage is uncertain, you will receive an Advanced Beneficiary Notification (ABN) form. This form explains the services offered, how Medicare will be billed, and any potential out-of-pocket costs. Read below for more information on services Medicare will cover and the services that may be offered at your annual appointment.
What Medicare Covers
Annual Women’s Wellness Visit
- Review of your health history, family history, and lifestyle factors.
- Not covered by Medicare unless Medicare Part B; cost is $60.
- Focuses on developing a personalized prevention plan. This visit is distinct from a traditional physical exam. If a physical exam is performed, cost-sharing may apply.
Screening Pap Smear
- Performed based on your age, previous history, and current guidelines.
- Covered based on age, medical history, and current guidelines.
Pelvic & Breast Exam
- Physical examination only; the health review is not included.
- Covered every 24 months, or every 12 months if high-risk criteria are met.
Problem-Based Visits
- Medicare fully covers visits for specific health problems at any time, as long as the appointment is scheduled as a problem visit
Patient Portal
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