I have Medicare, but also work full-time. I prefer to have a physical covered by my personal insurance, but the clinic keeps insisting on the Medicare check. I also don’t like the cognitive portion of the test. What say you? Thank you.
My PCP has never given me a breast exam. That was my GYN and then I made sure I had an xray before I saw him later in life. So no exam from him. Now over 65 does not need a Pap smear. I was so glad. My yearly consists of Heart and Lungs and questions related to how I am feeling. If I get my labs done before the visit we discuss them. If not, I get the paperwork then. The Labs are what are important to me. My thyroid, because my Mom and Aunt had problems in that area. Of course my Cholesterol. My kidney function, ect. At 73 I now want to make sure I am in working order. And if not, I catch something that may become a problem.
When Mom went to her Neurologist he did the basic test on her, the watch, putting things on a tray and asking her to remember them (I have never been able to do this) and the drawing a picture. I sat there thinking, I could not do that and she passed most of it.
No, if my doctor said he wanted to do a cognitive test, I would have declined. Why? Because I do not think a PCP is the one who should be administering that test. Nor should a NP.
Don't do it if you do not want to. This is your choice, and you can say no. The staff at the doctor's office cannot force you to follow their orders. It is especially odd to me when such an order is given to a patient without any explanation of why or what it is for. It makes me think they are doing something underhanded.
I have a general distaste for a health-related company that pushes this off on people because I wonder if they are fishing for "problems to fix". The default attitude is "you have a problem, and we are going to find it, label it, and force a corrective action on you". I prefer to let someone know when I have a problem.
While they are hesitant to do so, doctors CAN INDEED refuse to see a non-compliant patient who doesn't do reasonable followup visits. The doctor would tell the patient by letter that he is sorry to inform he cannot render adequate care without at least a yearly checkup or checkin and that he/she would be irresponsible in basically "abandoning" his patient without adequate oversite. A yearly checkup or checkin with a doc isn't unreasonable and may be a life saver.
With the previous medical practice, the doctor did the MMSE cognitive test every year. She left, then there was a PA. He never did the test. He never did breast exam but did listen to heart and lungs. Then he prescribed my meds and I was out of there till next year. The PA care was not really "care." But it got me my prescribed meds. A specialist I went to told me I deserved better from a PCP.
In my present medical practice, it's a yearly Medicare wellness visit with the doctor (third PCP in 4 years because most of the doctors left the practice during early Covid and weren't replaced, much to the detriment of the patients). I've never had a cognitive test but am constantly being evaluated by doctor and his assistant from the time I walk in the door until I leave. I can tell from the questions they ask and how carefully they watch my face and eye contact. Same with husband. Doctor writes his evaluation in the visit notes, which I access through the patient portal afterward. The doctor has been spot on.
No breast, no pelvic exam. We are assessed for mood, affect, demeanor, response. We have lab tests and are tested for oxy level, blood pressure, urine, etc. We discuss if we need to be referred to specialists for anything, but I find specialists myself as problems occur, so I don't depend on PCP for that.
THEY ARE WATCHING US. I'm not sure if this is a good thing or if it creeps me out.
It's annoying to me so I refuse it. I understand the reasons to establish baselines, but I don't like visiting doctors for fun, only if I really need to.
Since ur still working, isn't your Medicare secondary? If so, your insurance is billed first and then Medicare. Does your insurance cover yearly exams and labs because Medicare does.
I am 73 on traditional Medicare with a supplemental. I have never been asked to take a cognitive test. If I was, I would say no.
Wow, if such a visit exists, then at 81 and 83 respectively they surely are missing me and my partner! Neither he nor I have ever been asked to do such a thing. We are members of Kaiser and we do yearly see our doctor for what I call our "command performance" in that the doc asks how we are, listens to the heart, takes the BP, goes over your meds and any tests you both think appropriate to do that year, and then on you go.
Now I can imagine that there is conceivably a mental portion to this as it goes along, but no one ever asked me to spell Forum backwards or to draw the face of a clock set at a certain time.
Wish I could answer, but I find myself flummoxed that there is such a thing extant out there, and wondering if others are being requested to undergo a cognitive exam?
There is indeed an annual Medicare "Wellness" visit, and it includes some cognitive testing. I don't think it's mandatory by any means. My Dr. does this every year, but the Medicare "Wellness" coverage is pretty limited and doesn't include an actual physical exam for which I pay extra. https://www.medicare.gov/coverage/yearly-wellness-visits
Very good input here. Thank you!! I just wanted to do the physical under my own insurance as long as I’m working as it’s more comprehensive than the Medicare wellness exam. Maybe the clinic gets reimbursed more for Medicare exams?
I can see both sides honestly. I can understand why you would be sensitive, I think most of us are sensitive about that issue to begin with.
But that being said, I also think it is very important to be honest with yourself and frankly impower yourself to be the one in charge of you while you can.
Let me explain that a little bit. When I went into menopause, I frankly thought I knew what to expect. And for the most part, I did. With one glaring exception. I was not prepared for the cognitive impairment that can come with menopause. I knew all about hormonal changes, hot flashes, weight gain, mood swings, skin changes, blah blah blah. But I had no idea about the brain fog. And I had it BAD. And for months I suffered in silence and was terrified that I had something terribly wrong cognitively at 45 years old.
Finally I told myself that I had to take control and deal with whatever it was because if I did actually have something I might not have many more opportunities to be in charge of my own choices entirely. So I went to the doctor and described my symptoms and of course that's when I found out the reality. Silly in hindsight, but very scary when it was happening.
Very obviously not the same thing as dementia I recognize. But in the early stages I think many people have the ability to continue to reason and deny and rationalize away things. And I think that is true with a lot of medical conditions. Is it better to NOT know and not deal with it? Or know and face it head on? I think a lot of people just want to not know and pretend things aren't happening so they don't have to deal with it. Or are too embarrassed by what is happening so they don't want to tell anyone.
But here is the thing- it's ok to be sensitive. But maybe ask yourself WHY you are sensitive. Is it because you feel young and strong and healthy and it offends you that they think you need to be tested each year and other younger people don't? And that you feel that you will know when you need help? Or is it because you feel deep down that maybe you are experiencing some issues and you don't want anyone to know?
Let me give you another situation - and this is kind of what makes the cognitive test interesting to me. My FIL has recently been diagnosed with dementia. He moved to a nursing home about 4 months ago. As a family we have thought he had dementia for several years. He saw doctors CONSTANTLY. That was his thing. He saw about 9 doctors regularly, including a VA Primary and a Private Primary. Those last two didn't seem to agree about his cognition.
But his Private Primary was the one that administered the Medicare Wellness/Cognitive. He had a tremor. So every single year someone ELSE drew the clock FOR him and he just had to POINT. And he always managed to pass the thing with flying colors. No problem. He saw this primary for AT LEAST 15 YEARS.
But the very first family care plan meeting at the nursing home - the Charge Nurse advised us that they were recommending assessment for dementia and believed he was likely Stage 2. And by July, he was diagnosed. 3 months. That's all it took.
That quick cognitive assessment they do once a year - its a touch base. A baseline. They just want to make sure that you are staying at the same level. If they REALLY think you have cognitive decline of any significance they are going to recommend a deeper assessment. Believe it or not, doctors are assessing our mental health all the time. Every time I go, I have to tell them whether I feel sad or happy etc. That's not just for funsies. They input every answer I give into my file. They are always tracking where we are mentally or cognitively no matter what age.
I just wish they provided as much support and help for mental health on the back end as they do the tracking on the front end.
I have Medicare plus a Supplement (Part G). I just had the annual Medicare Wellness exam last week. I refused their ridiculous cognitive test for the second year in a row (name as many animals as you can). It was my doctor's nurse who suggested I could refuse it.
Additionally, I have a regular annual exam, but I don't know if my Supplement allows that or it's done as part of my contract with my (hybrid, as he does take insurance) concierge PCP.
I have a Medicare Advantage plan that is PPO. It covers my annual physical and some labs. I don't get a cognitive test as part of my annual physical. I do get a hearing test and a vision checkup.
Is someone suspecting you are having memory issues? I've been told that you don't have to pass all the tests to be of sound mind. My Mom at age 98 can count down by 7s with no problem, however she can't draw the clock.
I'd say go to another clinic for your wellness check or your annual physical or, just refuse the test.
When Mom went to her Neurologist he did the basic test on her, the watch, putting things on a tray and asking her to remember them (I have never been able to do this) and the drawing a picture. I sat there thinking, I could not do that and she passed most of it.
No, if my doctor said he wanted to do a cognitive test, I would have declined. Why? Because I do not think a PCP is the one who should be administering that test. Nor should a NP.
That task may STILL be in that test.
I still can’t pass it.
Standardized tests are great, but must be considered in context.
I have a yearly with my doctor, that is it.
I have a general distaste for a health-related company that pushes this off on people because I wonder if they are fishing for "problems to fix". The default attitude is "you have a problem, and we are going to find it, label it, and force a corrective action on you". I prefer to let someone know when I have a problem.
A yearly checkup or checkin with a doc isn't unreasonable and may be a life saver.
In my present medical practice, it's a yearly Medicare wellness visit with the doctor (third PCP in 4 years because most of the doctors left the practice during early Covid and weren't replaced, much to the detriment of the patients). I've never had a cognitive test but am constantly being evaluated by doctor and his assistant from the time I walk in the door until I leave. I can tell from the questions they ask and how carefully they watch my face and eye contact. Same with husband. Doctor writes his evaluation in the visit notes, which I access through the patient portal afterward. The doctor has been spot on.
No breast, no pelvic exam. We are assessed for mood, affect, demeanor, response. We have lab tests and are tested for oxy level, blood pressure, urine, etc. We discuss if we need to be referred to specialists for anything, but I find specialists myself as problems occur, so I don't depend on PCP for that.
THEY ARE WATCHING US. I'm not sure if this is a good thing or if it creeps me out.
I am 73 on traditional Medicare with a supplemental. I have never been asked to take a cognitive test. If I was, I would say no.
Now I can imagine that there is conceivably a mental portion to this as it goes along, but no one ever asked me to spell Forum backwards or to draw the face of a clock set at a certain time.
Wish I could answer, but I find myself flummoxed that there is such a thing extant out there, and wondering if others are being requested to undergo a cognitive exam?
But that being said, I also think it is very important to be honest with yourself and frankly impower yourself to be the one in charge of you while you can.
Let me explain that a little bit. When I went into menopause, I frankly thought I knew what to expect. And for the most part, I did. With one glaring exception. I was not prepared for the cognitive impairment that can come with menopause. I knew all about hormonal changes, hot flashes, weight gain, mood swings, skin changes, blah blah blah. But I had no idea about the brain fog. And I had it BAD. And for months I suffered in silence and was terrified that I had something terribly wrong cognitively at 45 years old.
Finally I told myself that I had to take control and deal with whatever it was because if I did actually have something I might not have many more opportunities to be in charge of my own choices entirely. So I went to the doctor and described my symptoms and of course that's when I found out the reality. Silly in hindsight, but very scary when it was happening.
Very obviously not the same thing as dementia I recognize. But in the early stages I think many people have the ability to continue to reason and deny and rationalize away things. And I think that is true with a lot of medical conditions. Is it better to NOT know and not deal with it? Or know and face it head on? I think a lot of people just want to not know and pretend things aren't happening so they don't have to deal with it. Or are too embarrassed by what is happening so they don't want to tell anyone.
But here is the thing- it's ok to be sensitive. But maybe ask yourself WHY you are sensitive. Is it because you feel young and strong and healthy and it offends you that they think you need to be tested each year and other younger people don't? And that you feel that you will know when you need help? Or is it because you feel deep down that maybe you are experiencing some issues and you don't want anyone to know?
Let me give you another situation - and this is kind of what makes the cognitive test interesting to me. My FIL has recently been diagnosed with dementia. He moved to a nursing home about 4 months ago. As a family we have thought he had dementia for several years. He saw doctors CONSTANTLY. That was his thing. He saw about 9 doctors regularly, including a VA Primary and a Private Primary. Those last two didn't seem to agree about his cognition.
But his Private Primary was the one that administered the Medicare Wellness/Cognitive. He had a tremor. So every single year someone ELSE drew the clock FOR him and he just had to POINT. And he always managed to pass the thing with flying colors. No problem. He saw this primary for AT LEAST 15 YEARS.
But the very first family care plan meeting at the nursing home - the Charge Nurse advised us that they were recommending assessment for dementia and believed he was likely Stage 2. And by July, he was diagnosed. 3 months. That's all it took.
That quick cognitive assessment they do once a year - its a touch base. A baseline. They just want to make sure that you are staying at the same level. If they REALLY think you have cognitive decline of any significance they are going to recommend a deeper assessment. Believe it or not, doctors are assessing our mental health all the time. Every time I go, I have to tell them whether I feel sad or happy etc. That's not just for funsies. They input every answer I give into my file. They are always tracking where we are mentally or cognitively no matter what age.
I just wish they provided as much support and help for mental health on the back end as they do the tracking on the front end.
Additionally, I have a regular annual exam, but I don't know if my Supplement allows that or it's done as part of my contract with my (hybrid, as he does take insurance) concierge PCP.
Is someone suspecting you are having memory issues? I've been told that you don't have to pass all the tests to be of sound mind. My Mom at age 98 can count down by 7s with no problem, however she can't draw the clock.
I'd say go to another clinic for your wellness check or your annual physical or, just refuse the test.