Medicare Annual Wellness Visits
What is included in the Annual Wellness Visit?
The provider may check to make sure the heart, lungs, and other body systems are working properly. The doctor will probably ask questions about your daily routine, medical history, memory, as well as take certain routine measurements like height, weight and blood pressure.
The annual wellness visit offers services that are not included in the Welcome to Medicare physical, such as an opportunity to develop a personalized prevention plan, to review the care you are receiving from other doctors, and to receive a cognitive function checkup.
Call the Care Coordinator at 618-357-8820 to schedule an appointment or to learn more!
What is an Annual Wellness Visit?
While Medicare does not cover a routine physical exam, an Annual Wellness Visit contains elements that are similar to a check-up or physical.
This is not a head-to-toe– physical; rather, it is an opportunity to discuss your current health and wellness. It can free up time during office visits so you and your provider can focus on your concerns.
Who is eligible?
Any Medicare beneficiary who:
Has been receiving Medicare Part B benefits for at least 12 months; and
Has not had an initial preventive physical examination (the “Welcome to Medicare” exam) or an Annual Wellness Visit within the past 12 months.
If you are new to Medicare, you must wait 12 months after your Welcome to Medicare physical before you can receive the annual wellness visit benefit. If you did not receive a Welcome to Medicare physical, then you must wait until the anniversary date of your enrollment to get an annual wellness visit.
How often will Medicare pay for an Annual Wellness Visit?
Medicare will pay for an Annual Wellness Visit once every 12 months.
Are there any deductibles or co-payments for the visit?
No. The Medicare Part B deductible and coinsurance payments do not apply to the Annual Wellness Visit.
What should you bring to the visit?
You should bring a complete list of your medications (including vitamins and over-the-counter drugs) or all your medication bottles for the doctor to review. You should also bring a list of your top two to three concerns or questions for the doctor. If you have concerns about your memory or a chronic health condition (such as diabetes, heart disease, or depression), you might consider bringing a family member or friend with you to the appointment.
Medicare Coverage of Physical Exams—Know the Difference
Initial Preventive Physical Examination (IPPE)
Review of medical and social health history, and preventive services education
üCovered only once within 12 months of Part B enrollment
üPatient pays noting (if providers accepts assignment)
Annual Wellness Visit (AWV)
Visit to develop or update a personalized prevention plan, and perform a health risk assessment
üCovered once every 12 months
üPatient pays nothing (if provider accepts assignment)
Routine Physical Examination
Exam performed without relationship to treatment or diagnosis for a specific illness, symptom, complaint, or injury
Not covered by Medicare; prohibited by statute
Patient pays 100% out-of-pocket
The Annual Wellness Visit may seem like a small thing, but it will help you take control of your health care. If you take full advantage of wellness visits, coupled with preventive care, it may mean the difference between sickness and health. Of course, if you do get sick, Medicare will cover your doctor and hospital bills the same as always.