The Annual Wellness Visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan to help you avoid illness, based on your current health and risk factors.
Keep in mind that the Annual Wellness Visit is not a head-to-toe physical. Rather, it is similar to, but separate from, the one-time Welcome to Medicare preventive visit.
Medicare Part B covers a wellness visit if you have had Part B for over 12 months and you have not had a wellness visit within the past 12 months.
Additionally, you cannot undergo a wellness visit within the same year as your Welcome to Medicare preventive visit.
Developing a personalized prevention plan
Your primary care physician may do the following:
- Check your height, weight, blood pressure, and other routine measurements
- Give you a health risk assessment, which may include a questionnaire that you complete before or during the visit, regarding your health status, injury risks, behavioral risks, and urgent health needs
- Review your functional ability and level of safety
- Learn about your medical and family history
- Make a list of your current providers, durable medical equipment suppliers, and medications
- Create a written 5 to 10-year screening schedule or checklist
- Identify risk factors and current medical and mental health conditions, along with related current or recommended treatments
- Screen for cognitive impairment, including diseases such as Alzheimer’s and other forms of dementia
- Review risk factors for depression
- Provide health advice and referrals to health education and/or preventive counseling services aimed at reducing identified risk factors and promoting wellness. This may relate to weight loss, physical activity, smoking cessation, flu prevention, nutrition, and more
Annual Wellness Visits going forward may include:
- Check your weight and blood pressure
- Update the health risk assessment you completed
- Update your medical and family history
- Update your list of current medical providers and suppliers
- Update your written screening schedule
- Screen for cognitive issues
- Update your list of risk factors and conditions and the care you are receiving or that is recommended
- Provide health advice and referrals to health education and/or preventive counseling services.
During these visits, your provider may discover a new or existing problem requiring investigation and/or treatment.
This additional care is considered diagnostic, meaning your provider is treating you because of certain symptoms or risk factors. Medicare may bill you for any diagnostic care you receive during a preventive visit, including your Annual Wellness Visit.
This content was created and copyrighted by the Medicare Rights Center ©2020. Medicare Rights Center is a national, nonprofit consumer service organization that works to ensure access to affordable health care for older adults and people with disabilities. These materials are presented here with support from YourMedicare.com and may not be distributed, modified or edited without Medicare Rights’ consent.
YourMedicare.com takes pride in providing you as much information as possible concerning your Medicare options, but only a health insurance broker licensed to sell Medicare can help you compare your plan options from various insurance companies. When you’re ready, we recommend you discuss your needs with a YourMedicare.com Licensed Sales Agent.