Those with Medicare Part B for longer than 12 months can get a Medicare Annual Wellness Visit to update a personal disease prevention plan. The prevention plan is based on your current health risk factors.

For the most part, this visit is a conversation with your doctor about health risk prevention and routine measurements.

What is the Medicare Annual Wellness Visit?

The Annual Wellness Visit is meant to check routine measurements like height, weight, blood pressure, and health risks. Your doctor will also look for signs of dementia, including Alzheimer’s disease.

You can expect your doctor to discuss:

  • Height, weight, blood pressure
  • Detect cognitive impairment
  • Personalized health advice
  • Tobacco and alcohol use
  • Urinary incontinence
  • Mobility issues
  • Risk factors and treatment options
  • Screening schedule or checklist for preventive services
  • Review of medical and family history
  • Creating a list of doctors and medications
  • Flu shots
  • Advance Care Planning
  • And more

If your doctor suspects you struggle with cognitive impairment, Medicare will cover a separate visit that includes a more thorough review of your cognitive functions. The second visit will screen for dementia, depression, anxiety, and delirium.

Your doctor may refer you to a specialist for disease screenings and ask questions to determine your need for social services. The goal is to keep you healthy and address issues that affect your health.

The Annual Wellness Visit isn’t a physical exam. Also, the “Welcome to Medicare” visit is different from the annual checkup.

What Do I Bring To My Medicare Annual Wellness Visit?

When going to your annual wellness visit be sure to bring information on your family history, immunization history, surgical history, and personal health history. You’ll also want to bring a list of your current medications and doctors.

Your doctor will review your medications for drug interactions and set up refills. They will also ensure your medical records have an updated list of medications.

What is Not Covered In Medicare Annual Wellness Visit?

To most people’s surprise, the Medicare Annual Wellness Visit doesn’t include a physical exam. Also, if services go beyond prevention, you may incur charges.

Medicare won’t cover a cholesterol screening at this visit unless it’s related to a specific medical condition.

FAQs

Is an Annual Wellness Visit required by Medicare?

The Medicare Annual Wellness Visit isn’t mandatory, but it is a free visit you can take advantage of once a year. If you choose not to go to an annual wellness visit there isn’t a penalty, and you’ll still have your Medicare coverage.

How often can you get a Medicare Annual Wellness Visit?

Every 12 months you can meet with your Primary Care Physician to develop a personalized disease prevention plan based on your current health risk factors.

What is the difference between a Wellness Visit and a physical?

The Medicare Annual Wellness Visit is less extensive than a physical. A physical would include things like bloodwork and other tests that don’t take place at the Medicare Annual Wellness Visit.

How much does the Medicare Annual Wellness Visit cost?

If you see a physician that accepts “Medicare Assignment”, your visit won’t cost you anything. The Part B deductible won’t apply. But, if your doctor runs additional tests that aren’t preventive benefits, you may be subject to paying the 20% coinsurance.

Can Medicare Supplement Insurance Help Cover the Gaps of Medicare

While the Medicare Annual Wellness Visit may have no cost to you, the visit to a specialist or the hospital is costly. With a Medicare Supplement plan, you don’t need to worry about the 20% coinsurance associated with Medicare because your insurance company will pay that depending on which plan you select.

To find out more about the Medigap plans in your area call your licensed insurance agent today at the number above. Or, to see your insurance options online fill out an online rate form now.

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by Lindsay Malzone, Lindsay Malzone is the Medicare expert for Medigap.com. She's been contributing to many well-known publications as an industry expert since 2017. Her passion is educating Medicare beneficiaries on all their supplemental Medicare options so they can make an informed decision on their healthcare coverage.