Geriatric primary care is ongoing medical care built around the way aging changes health: how diseases show up, how medications behave, how well you move and think, and what you want from your later years. It can come from a geriatrician or from an internist or family physician who pays close attention to those issues. What matters most is that one trusted doctor keeps the whole picture, so your health has a home base.
This guide explains what geriatric primary care includes, how it differs from general adult care, what Medicare covers, how to prepare for a first visit, and what to look for in a practice. We are Macie Medical, a primary care practice in Katy, Texas, and we say plainly where our own care fits.
TL;DR
- Geriatric primary care looks at the whole person: chronic conditions, medications, memory, mobility, mood, safety and personal goals, not just the complaint of the day.
- A geriatrician is an internal medicine or family medicine physician with added training in older adults, but many excellent senior primary care doctors are internists who focus on this age group.
- Original Medicare covers a Welcome to Medicare visit and a yearly Annual Wellness Visit, and many covered preventive services cost nothing when the conditions are met.
- Bring your medication bottles, your questions and a family member if you like. A good visit ends with a written plan you understand.
- Macie Medical offers adult and senior primary care, chronic care management and same-day sick visits in Katy, with telehealth for patients anywhere in Texas.
Table of Contents
- What geriatric primary care means
- How geriatric care differs from general adult primary care
- The 5 Ms of geriatric care
- What a geriatric primary care visit includes
- What Medicare covers for senior primary care
- How to prepare for a first senior primary care visit
- Signs you may benefit from a more geriatric-focused approach
- What to look for in a senior primary care practice
- Our perspective: care that gives you time
- Primary care for older adults at Macie Medical
- FAQ
- Sources
What geriatric primary care means
Primary care is the doctor you see first and most often. Geriatric primary care keeps that role but adds a lens for older age. The American College of Physicians describes geriatric medicine as a type of internal medicine focused on older patients, with training in age-related physical and psychosocial changes, differences in how disease presents, functional independence and preventive care.
That last point is practical. In later life, a urinary infection may appear as sudden confusion rather than burning. A new medication may cause dizziness that leads to a fall. Fatigue may have three overlapping causes instead of one. A doctor who expects these patterns spends the visit differently.
Geriatrician, internist or family doctor?
The American Geriatrics Society says geriatricians are physicians trained to evaluate and manage older adults’ distinctive health needs and treatment preferences, with emphasis on well-being, independence and person-centered care.
In plain terms, you have three common routes to senior primary care:
- A board-certified geriatrician. The deepest training in aging, and often the right match if you have many conditions, memory concerns, frailty or a complicated medication list. Supply is limited, so waits can be long.
- An internal medicine physician. Internists are trained in adult medicine, including chronic disease and complex cases, and many build a practice largely around patients in their 60s, 70s and beyond.
- A family medicine physician. A good choice if you want one doctor for yourself and perhaps a spouse or adult children too.
Our own founder, Dr. Judith Aniekwena, is board certified in internal medicine and obesity medicine. We are not a geriatrics subspecialty clinic, and we would rather say so than blur the line. What we offer is the continuity, time and coordination that make senior primary care work, and we refer to a geriatrician or specialist when your situation calls for one. For a broader look at the choice, see our guide on what kind of doctor is best for seniors.
How geriatric care differs from general adult primary care
The difference is less about different tests and more about priorities. A younger adult visit often centers on one problem or a screening list. A geriatric visit widens the frame.
| Focus | Typical adult visit | Geriatric-minded visit |
|---|---|---|
| Medications | Prescribe for the condition | Review every pill and supplement, look for overlap, side effects and doses that no longer fit |
| Symptoms | Match to common causes | Expect atypical presentation and several contributing causes |
| Function | Rarely asked | Ask about bathing, cooking, driving, managing money and stairs |
| Prevention | Standard screening schedule | Screening tailored to health status, life expectancy and preferences |
| Goals | Assumed: treat the disease | Asked: what do you most want to keep doing? |
| Family | Optional | Caregivers are part of the plan when you want them to be |
It is a way of working that fits older adults, and it also suits anyone with several conditions at once. If you are weighing practices, our article on finding the best primary care for seniors walks through the same decision from a patient’s side.
The 5 Ms of geriatric care
Clinicians often use a short framework called the Geriatric 5 Ms, launched in 2017 by Canadian and US geriatric specialists. According to a review of the framework in the NIH’s PubMed Central library, the five areas are mind, mobility, medications, multicomplexity and matters most. It is a useful checklist for you, too, because it shows what a thorough senior visit should touch on.
- Mind. Memory, thinking, mood and delirium. This includes screening for depression and early cognitive change, which is easier to address when found early.
- Mobility. Balance, gait and fall prevention. A few questions and a short walking test can tell a lot. Staying strong and steady is also the basis of independence, and resources such as balance training for seniors show the kinds of exercises commonly discussed for reducing fall risk.
- Medications. Polypharmacy, deprescribing and side effects. The goal is the right medicines at the right doses, not simply fewer or more.
- Multicomplexity. Several chronic conditions, plus the social and practical circumstances around them, such as living alone, transportation or caregiver strain.
- Matters most. Your own goals. Some people want to travel, some want to stay in their home, some want to play with grandchildren without pain. Treatment choices should serve those goals.
Notice that “matters most” comes last in the list but shapes everything else. A plan that ignores it may be medically tidy and still wrong for you.
What a geriatric primary care visit includes
The American Geriatrics Society’s competency framework describes comprehensive geriatric assessment as a look at physical, functional, mental, emotional, medication-related and social-environmental status, used to build a coordinated treatment and follow-up plan. The same document treats older-adult care as a team effort among clinicians, therapists, pharmacists, social workers and caregivers.
In day-to-day practice, that usually means:
- Chronic condition management. Blood pressure, diabetes, thyroid disease, heart disease, kidney health, arthritis and lung disease, with regular follow-up and lab work. Our page on managing chronic diseases in primary care explains how we approach this, and our senior chronic care management article covers the between-visit support.
- A full medication review. Prescriptions, over-the-counter products, vitamins and herbal supplements, checked together.
- Preventive care. Immunization and screening guidance, based on your history and current recommendations, plus health promotion such as nutrition and activity.
- Safety checks. Fall risk, vision and hearing, home safety, and awareness of elder mistreatment risk.
- Memory and mood screening. Brief, routine and non-alarming when done well.
- Care coordination. Referrals, specialist reports, hospital follow-up and a single place where it all comes together.
The fuller version of why one coordinating doctor matters is in our piece on the benefits of regular primary care visits.
What Medicare covers for senior primary care
The question most families ask first is whether Medicare will pay for a geriatric doctor. Medicare covers care by qualifying physicians under Part B, and what matters is the service and whether the doctor accepts Medicare, not the label “geriatrician.” Your exact cost depends on your plan, so confirm with your own plan and with the practice before you book. What the official sources do say about preventive care is encouraging.
Welcome to Medicare visit
CMS says the Welcome to Medicare preventive exam is covered once in a lifetime when furnished within the first 12 months of Part B coverage. It includes medical and social history, depression-risk review, functional and safety review, measurements, preventive counseling and referrals. It also reviews medications and supplements, diet, physical and social activities, fall risk, hearing impairment, and home and community safety, which makes it a ready-made agenda for your first senior visit.
Annual Wellness Visit
After that, the Annual Wellness Visit is the yearly planning appointment. According to CMS, it includes a health-risk assessment, medical and family history, medication and provider review, cognitive and depression-risk detection, a functional and safety assessment, measurements and a written screening schedule for the next 5 to 10 years. CMS notes that the initial visit is covered once and later visits annually for eligible beneficiaries, with deductible and coinsurance waived for the covered Annual Wellness Visit.
This visit is not the same as a head-to-toe physical. We explain the difference in annual physical vs. wellness visit, and what happens in the room in what to expect during your annual checkup.
Other covered services worth knowing
- Preventive services in general. Medicare.gov says Original Medicare covers preventive exams, screenings, vaccines and counseling, and many cost you nothing when coverage conditions are met.
- Cognitive assessment and care planning. When memory or thinking changes are suspected, CMS describes a service that can apply to people with dementia, mild cognitive impairment, or clinically judged cognitive impairment without a prior diagnosis, and it results in a written care plan.
- Advance care planning. CMS says voluntary advance care planning is an optional Annual Wellness Visit element, and when done the same day by the same provider as a covered visit, deductible and coinsurance do not apply.
- Chronic care management and related support. CMS lists chronic care management, caregiver training, depression screening and behavioral health integration among services Medicare may cover, each subject to its own requirements.
Coverage rules change, and Medicare Advantage plans have their own networks and costs. Call the number on your insurance card, or ask our front desk, before scheduling.
How to prepare for a first senior primary care visit
A little preparation turns a rushed appointment into a useful one. Many patients find the following manageable:
- Gather every medication. Bring the bottles themselves, including patches, inhalers, eye drops, vitamins and anything you buy over the counter.
- Collect your records. Names of your specialists, recent test results, hospital discharge papers, immunization records and a list of past surgeries.
- Write down your top three concerns. If you only have time for three, which matter most? Include things you may think are “just aging,” such as sleep, bladder changes, forgetfulness or unsteadiness.
- Note recent changes. Falls or near falls, weight change, appetite, mood, new pain.
- Think about your goals. What do you want your next five years to look like?
- Bring a second set of ears. A spouse, child or friend can help you remember the plan. If you prefer to keep the visit private, that is your choice, and we respect it.
- Bring your glasses and hearing aids. They affect screening results and how well you take in the conversation.
Our annual physical exam checklist and preparation guide for an annual physical add more detail.
Signs you may benefit from a more geriatric-focused approach
Age alone does not decide this. Consider it when:
- You take five or more medications, or see several specialists who do not seem to talk to each other.
- You have had a fall, or you are afraid of falling.
- You or your family have noticed memory changes.
- A recent hospital stay left you weaker or more confused than before.
- You are caring for a spouse while your own health slips down the list.
- You feel rushed at appointments and leave without a clear plan.
If you notice sudden confusion, chest pain, trouble breathing, stroke symptoms or a serious fall with injury, call 911 or go to the nearest emergency room rather than waiting for an appointment.
What to look for in a senior primary care practice
Beyond credentials, ask practical questions:
- Time. How long are visits, and can you reach the office between them?
- Access. Are same-day sick visits available? Is there telehealth for follow-ups, so a winter cold or a mobility problem does not mean skipping care?
- Coordination. Who tracks specialist reports and hospital discharges?
- Labs on site or nearby. Fewer trips matter when getting around is harder.
- Insurance and payment clarity. Which plans are accepted, and what are self-pay options?
- Whether you feel heard. This is the one that predicts whether you will keep going.
Our article on choosing a doctor for your aging needs and the guide to choosing an adult primary care clinic that fits expand on these.
Our perspective: care that gives you time
The name Macie means “gift,” and we try to treat the time with each patient that way. In our experience, the best thing primary care can offer an older adult is not a longer list of tests. It is a doctor who knows you, notices what has changed since last time, and explains the plan until it makes sense to you and, when you wish, to your family.
We believe in three habits. First, we review the whole medication list at every meaningful visit, because the list drifts over the years. Second, we ask what matters most to you before we recommend anything, because a plan you will not follow protects no one. Third, we treat the person, not only the diagnosis: faith, family, finances, loneliness and worry all affect health, and we make room to talk about them.
We also know our limits. When you need a geriatrician, a cardiologist, a memory specialist or a physical therapist, we help you get there and keep the thread of your care together afterward.
— the author
Primary care for older adults at Macie Medical
We provide adult and senior primary care in Katy, along with chronic care management, annual physicals, on-site lab services and same-day sick visits. Telehealth appointments are available for patients anywhere in Texas. We serve patients from Katy, Cypress, Richmond and Memorial City, and starting November 16, 2026, we welcome patients at our new, larger office at 633 E Fernhurst Dr, Suite 205, Katy, TX 77450.
If you prefer a straightforward self-pay option, our cash-pay clinic page lists Package 1 at $500 per year, Package 2 at $700 per year and additional visits at $150 per visit. You can also explore our primary care services, or read why choose Macie Medical. When you are ready, call or book online and tell us what you want to get out of your first visit.
FAQ
What type of physician treats elderly patients?
Geriatricians are physicians specifically trained in the health needs of older adults. Many older adults are also well cared for by internal medicine or family medicine physicians who act as their primary care doctor and bring in specialists as needed. The best fit depends on how complex your health is and how available each type of doctor is near you.
Will Medicare pay for a geriatric doctor?
Medicare pays for covered services from qualifying doctors who accept it, whatever their specialty label. That includes the Welcome to Medicare visit, the yearly Annual Wellness Visit and many preventive services. Your own costs depend on your plan, so check with your plan and the practice before you schedule.
Do I need a geriatrician, or is a regular primary care doctor enough?
Many people do well with an experienced internist or family physician who reviews medications, screens for memory and fall risk, and coordinates specialists. A geriatrician is especially helpful with multiple serious conditions, frailty, repeated falls, or significant memory loss. If you are unsure, your primary care doctor can tell you when a referral makes sense.
At what age should I start seeing a doctor for senior care?
There is no single age. Medicare eligibility at 65 is a natural time to establish a long-term doctor and use the Welcome to Medicare visit. Some people benefit earlier if they have complex chronic conditions, and others stay with a general adult doctor well into their 70s.
Can I see a primary care doctor by telehealth as a senior?
Often, yes, for follow-ups, medication reviews and many sick concerns. Some things still need an in-person visit, such as a physical exam, certain screenings and labs. At Macie Medical, telehealth is available for patients anywhere in Texas, alongside in-person visits in Katy.
Sources
- Training for Geriatricians, American Geriatrics Society
- Geriatric Medicine, American College of Physicians
- Optimizing geriatric care with the Geriatric 5Ms, PubMed Central
- Partnership for Health in Aging: Multidisciplinary Competencies, American Geriatrics Society
- Initial Preventive Physical Exam, CMS
- Annual Wellness Visit, CMS
- Medicare Preventive Services quick reference chart, CMS
- Your Guide to Medicare Preventive Services, Medicare.gov
- Billing and Coding: Cognitive Assessment and Care Planning, CMS
- Advance care planning guidance, CMS transmittal R216BP
- Medicare and Mental Health Coverage, CMS
- Balance Training for Seniors: Safe Exercises to Prevent Falls
