That’s not true. You can’t sign up just when you get sick. That’s why there are Open Enrollment periods, and you can only sign up outside of Open Enrollment if you have a major life event (wedding/divorce/kids/new job/moved/etc). Just like normal, private insurance.
1 Like
Here are the requirements for the annual wellness check:
ELEMENTS OF THE INITIAL ANNUAL WELLNESS VISITEstablishment of the patient’s medical and family history:
Past medical and surgical history, including illnesses, hospital stays, operations, allergies, injuries and treatments. Use or exposure to medications and supplements, including calcium and vitamins. Medical events experienced by the beneficiary's parents and any siblings and children, including diseases that may be hereditary or place the individual at increased risk.Establishment of a list of current providers and suppliers who are regularly involved in providing medical care to the individual.
Measurement of the individual’s height, weight, body mass index (or waist circumference, if appropriate), blood pressure and other routine measurements as deemed appropriate, based on the individual’s medical and family history.
Detection of any cognitive impairment that the individual may have by direct observation, with due consideration of information obtained by way of patient report or concerns raised by family members, friends, caretakers or others.
Review of the individual’s potential risk factors for depression, including current or past experiences with depression or other mood disorders, based on the use of an appropriate screening instrument for persons without a current diagnosis of depression, which the health professional may select from various available screening questions or standardized questionnaires designed for this purpose and recognized by national professional medical organizations.
Review of the individual’s functional ability and level of safety, based on direct observation or the use of appropriate screening questions or a screening questionnaire, which the health professional may select from various available screening questions or standardized questionnaires designed for this purpose and recognized by national professional medical organizations. This includes at minimum review or screening for hearing impairment, ability to perform activities of daily living, fall risk and home safety.
Establishment of the following:
A written screening schedule, such as a checklist, for the next 5 to 10 years as appropriate, based on recommendations of the USPSTF and the Advisory Committee on Immunization Practices, and the individual's health status, screening history and age-appropriate preventive services covered by Medicare. A list of risk factors and conditions for which primary, secondary or tertiary interventions are recommended or are underway, including any mental health conditions or any such risk factors or conditions that have been identified through an initial preventive physical examination (IPPE), and a list of treatment options and their associated risks and benefits.Furnishing of personalized health advice to the individual and a referral, as appropriate, to health education or preventive counseling services or programs aimed at reducing identified risk factors and improving self management, or community-based lifestyle interventions to reduce health risks and promote self-management and wellness, including weight loss, physical activity, smoking cessation, fall prevention and nutrition.
“Voluntary advance care planning,” which means verbal or written information regarding the following areas:
An individual's ability to prepare an advance directive in the case where an injury or illness causes the individual to be unable to make health care decisions. Whether or not the physician is willing to follow the individual's wishes as expressed in an advance directive.ELEMENTS OF SUBSEQUENT ANNUAL WELLNESS VISITS
An update of the individual’s medical and family history.
An update of the list of current providers and suppliers who are regularly involved in providing medical care to the individual, as that list was developed for the first AWV providing personalized prevention plan services.
Measurement of an individual’s weight (or waist circumference), blood pressure and other routine measurements as deemed appropriate, based on the individual’s medical and family history.
Detection of any cognitive impairment that the individual may have.
An update to both of the following:
The written screening schedule for the individual that was developed at the first AWV providing personalized prevention plan services. The list of risk factors and conditions for which primary, secondary or tertiary interventions are recommended or are underway for the individual – the list that was developed at the first AWV providing personalized prevention plan services.Furnishing of personalized health advice to the individual and a referral, as appropriate, to health education or preventive counseling services or programs.
“Voluntary advance care planning,” which means verbal or written information regarding the following areas:
An individual's ability to prepare an advance directive in the case where an injury or illness causes the individual to be unable to make health care decisions. Whether or not the physician is willing to follow the individual's wishes as expressed in an advance directive. </blockquote>I’m assuming that somewhere along the way, a list of general assessment questions was linked to the wellness visit and then “Obama is going to share your sex info with his IRS army”
This appears to be the actual law:
42 CFR 410.15 - Annual wellness visits providing Personalized Prevention Plan Services: Conditions for and limitations on coverage. | Title 42 - Public Health | Code of Federal Regulations
Aaand, one more volley:
Here are the FAQ/ABC’s of the Initial Preventive Physical and the Annual Wellness checks.
I think that these are the source of death panels (suggestion to discuss end of life options); and by linking to some sort of recommended health screening questions, probably the sex stuff.
Medicare Preventive Services Quick Reference Information: The ABCs of Providing the Annual Wellness Visit - AWV_Chart_ICN905706.pdf
Slide 1 - ippe_awv_call_presentation.pdf
Medicare Preventive Services Quick Reference Information: The ABCs of Providing the Initial Preventive Physical Examination - MPS_QRI_IPPE001a.pdf
I don’t think that this stuff is part of the normal ACA – I think that this is just the Medicare part of the ACA.
There’s an enrollment window for 2014 that ends in March. I suppose if your “whoops, I need insurance after all!” incident happens in the first 2.5 months of the year, you can pull that stunt. But if you have your drunken skiing accident in November, bummer for you. Which is why “hey, pay a fine and you won’t have insurance!” is so profoundly stupid.
You mean the exclusively LIE-beral SCOTUS? Invalid according to the 45th amendment.
This topic was automatically closed after 5 days. New replies are no longer allowed.
