Social determinants of health risk assessment
Medicare Part B (Medical Insurance) covers a social determinants of health risk assessment when your doctor or other health care provider gives it to you during your yearly “Wellness” visit, or as part of another office or behavioral health visit
Description
Social determinants of health are non-medical factors that can impact your health and quality of life, like your:
- Living environment
- Access to food
- Employment status
- Education and literacy levels
- Family circumstances
A social determinants of health risk assessment helps your provider understand your social needs to better treat you and refer you for appropriate services or supports. If your provider finds that you have social determinants of health needs, you may be able to get Medicare-covered community health integration services and/or principal illness navigation services to address them.
Costs
- You pay nothing for this risk assessment if you get it as part of your yearly “Wellness” visit.
- After you meet the Part B deductible , you pay 20% of the Medicare-approved amount if you get the risk assessment as part of another office or behavioral health visit.
How often
You can get this risk assessment from your health care provider once every 6 months (or more often if you go to more than one provider).
Ask your doctor or healthcare provider how much your test, item, or service will cost.
Your doctor may recommend services that Medicare does not cover or offers too frequently. This could end up in additional costs for you. Make sure to ask your doctor about the reasons for these recommendations and what Medicare will actually cover.
Specific amounts you could owe depend on:
Other insurance you may have
How much your doctor charges
If your doctor accepts assignment
The type of facility
Where you get your test, item, or service