Social determinants of health risk assessment

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

Medicare Part B (Medical Insurance) covers this 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. You can get this risk assessment from your provider once every 6 months (or more often if you go to more than one provider).

Your costs in Original Medicare

  • 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.

What it is

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.

Is my test, item, or service covered?