If you’re new to Medicare, or even for if you have been a part of a plan for some time, understanding your benefits and planning your medical visits can be confusing. As we enter a new year, The Greenbrier Clinic is here to help.

Use the information below to assist in understanding various terms frequently used by Medicare and the services to which you are entitled as a member. If you have any questions, feel free to call The Greenbrier Clinic Billing Department at 304-536-4870.

 Initial Preventative Physical Exam (IPEE)

The IPEE is a review of medical and social health history, and it also includes education about other preventative services.

  • Medicare will cover 1 IPPE per lifetime for patients within the first 12 months after their Part B benefits eligibility date.
  • Medicare will cover the entire cost of IPPE if the provider accepts the assignment.

Annual Wellness Visit (AWV)

The AWV is used to develop or review a patient’s personalized prevention plan. It also includes a health risk assessment.

  • Medicare will cover an annual AWV for patients who aren’t within the first 12 months after their Part B benefits eligibility date.
  • Medicare will cover an annual AWV 12 months after the last AWV (or IPPE) service.
  • Medicare will cover the entire cost of the AWV if the provider accepts the assignment.

Routine Physical Exam

A routine physical exam is an exam performed without relationship to treatment or diagnosis of a specific illness, symptom, complaint or injury.

  • Medicare doesn’t cover a routine physical.
  • Patients pay 100 percent out of pocket.

Screening Services

Medicare will pay the cost of many screening services. Some are paid once in a lifetime, while others are paid annually.

  • One-time “Welcome to Medicare” preventive visit — get this within the first 12 months you have Medicare Part B.
  • Yearly Wellness Visit — get this visit 12 months after your “Welcome to Medicare” preventive visit or 12 months after your Part B coverage starts.
  • Abdominal aortic aneurysm screenings
  • Alcohol misuse screenings & counseling
  • Bone mass measurements
  • Cardiovascular behavioral therapy
  • Cardiovascular disease screenings (cholesterol, lipids, triglycerides)
  • Cervical & vaginal cancer screenings
  • Colorectal cancer screenings
  • Counseling to prevent tobacco use & tobacco caused disease
  • COVID-19 vaccines
  • Depression screenings
  • Diabetes screenings
  • Diabetes self-management training
  • Flu shots
  • Glaucoma screenings
  • Hepatitis B shots
  • Hepatitis B Virus (HBV) infection screenings
  • Hepatitis C screenings
  • HIV (Human Immunodeficiency Virus) screenings
  • Lung cancer screenings
  • Mammograms (Breast cancer screenings)
  • Medical nutrition therapy services
  • Medicare Diabetes Prevention Program
  • Obesity behavioral therapy
  • Pneumococcal shots
  • Prostate cancer screenings
  • Sexually transmitted infection screenings & counseling