What to Expect at a Medicare Annual Wellness Visit
You may have been told you are due for a Medicare annual wellness visit. The name can sound like a yearly checkup. But it’s an appointment focused on prevention and planning, not a full physical exam. This article explains what happens, what is not included and who qualifies.
What Is a Medicare Wellness Visit?
A Medicare annual wellness visit is a conversation with your provider about your health risks and goals. Together, you create or update a personalized prevention plan. The plan includes a schedule for preventive screenings and vaccines that fit your age and health. The focus is on planning ahead, not diagnosing or treating symptoms.
Medicare Wellness Visit vs. Physical: What’s the Difference?
- Annual wellness visit: This is a review of your health history and risk factors, a few routine measurements and a written prevention plan.
- Physical exam: A hands-on exam of the body, during which your provider may listen to the heart and lungs, check reflexes and look for physical and mental changes.
What to Expect at a Medicare Wellness Visit
Before you go, gather a list of your medicines and supplements, the names of your other providers and any vaccination records you have.
- Health risk assessment: Before or during the visit, you’ll complete a questionnaire about your health, daily habits and ability to do everyday tasks.
- Medical and family history: Your provider will review past illnesses, surgeries and health conditions that run in your family.
- Current providers and prescriptions: You and your provider will talk about other doctors you see and the medicines and supplements you take. Your provider can also answer questions about how your medications may affect you.
- Routine measurements: Your provider may check your height, weight, blood pressure and other measurements if needed.
- Cognitive screening: Your provider may ask a few questions about memory and thinking.
- Depression and safety screening: At your first annual wellness visit, your provider may ask about your mood, home safety and risk of falls.
- Health advice: Your provider can share advice based on your needs, such as your physical activity and eating habits.
- Advance care planning: Your provider may offer to talk with you about advance directives, documents that record your wishes for future medical care.
- Personalized prevention plan: You can leave with a written checklist of the screenings, vaccines and other preventive services recommended for you.
What Is Not Included in a Medicare Annual Wellness Visit?
An annual wellness visit does not include:
- A full physical exam
- Lab work, such as blood tests
- Imaging, such as X-rays
- Treatment for new symptoms or ongoing health problems
If you bring up a new or ongoing health concern, your provider may treat it as a separate service with its own billing. Ask what is included when you schedule. To learn about your benefits, consult your insurance plan or visit Medicare’s page on yearly wellness visits.
Medicare Wellness Visit Requirements: Who Qualifies and How Often
You qualify for an annual wellness visit once you have had Medicare Part B for more than a year. If you had a “Welcome to Medicare” visit, it must also be 12 months since that visit. After your first wellness visit, you can have one every 12 months. The 12 months count from the date of your last visit.
You do not need a referral for either visit.
How the “Welcome to Medicare” Visit Differs
The “Welcome to Medicare” preventive visit is a one-time appointment you can use during your first 12 months with Medicare Part B. You’ll review your health risks and screening needs, and your provider may also conduct a vision test. Your first annual wellness visit can be scheduled 12 months after your “Welcome to Medicare” visit.
Does Medicare Require Annual Wellness Visits? Can You Refuse One?
No, Medicare does not require an annual wellness visit. You can decline the appointment or any part of it, such as the cognitive screening or the conversation about advance directives.
Still, it can be worth attending. It sets aside time to focus on prevention and keeps your screening schedule up to date. It also gives your provider a baseline to compare against, which is important to have even if you feel fine.
Common Questions About Medicare Wellness Visits
Is a Medicare wellness visit free?
Costs can depend on your Medicare plan and the services you receive during the visit. Before your appointment, check with your plan to learn about your benefits. You can also ask the provider’s office about billing when you schedule.
What if your last wellness visit was less than 12 months ago?
You will need to wait until a full 12 months have passed. Ask the office to check the date of your last visit.
Does a Medicare wellness exam include blood work?
No. Your provider may order lab tests separately if your care or a recommended screening calls for them. If you want to go over results during your appointment, ask about having blood work done a few days ahead.
Do you need to fast before a wellness visit?
You do not need to fast for the annual wellness visit. If your provider orders blood work, you may need to fast before your lab draw.
Can a nurse practitioner or PA perform a wellness exam?
Yes. Physicians, physician assistants, nurse practitioners and clinical nurse specialists can complete a wellness visit.
Schedule Your Medicare Annual Wellness Visit at Wood County Hospital
Primary care providers at Wood County Hospital can perform your annual wellness visit and help you build your prevention plan. To schedule, use our Find a Provider directory to choose a primary care provider near you and call their office.