Medicare Annual Wellness
What is a Medicare Annual Wellness Visit?
What to Expect:
- Health Risk Assessment: You’ll complete a questionnaire to assess your health and risk factors.
- Review of Medical History: Your doctor will review your medical and family history, current medications, and more.
- Personalized Prevention Plan: Based on your assessment, your doctor will create a plan with recommended screenings and other preventive services.
- Cognitive Assessment: You may be screened for cognitive impairment.
- Functional Ability and Safety: Your doctor will assess your ability to perform daily tasks and screen for fall risks.
- Other: Routine measurements (like height, weight, and blood pressure) and advance care planning.
Annual Wellness Visits Are Not a Physical Exam
- It’s different from a physical exam, as it primarily focuses on reviewing your health history, risks, and creating a prevention plan.
- Medicare does not cover chronic condition treatment including medication refills, bloodwork, X-rays, and lab tests during an Annual Wellness Visit.
- Patients will be charged for these services separately if they are completed during the same visit.
- It is very likely a provider may identify missing screenings or panels in a patient’s medical history.
- Coinsurance, co-pays and/or deductibles will apply to anything that is not part of the Annual Wellness Visit.
For more information about Medicare visit: www.medicare.gov
What You Need to Know About Cost of Your Visit
Type of Visit and Cost to Patient | |||||||
Wellness Preventative Visit Well Woman or Male Non-Medicare (No Cost) | Medicare Annual Wellness Visit (No Cost) | Problem Focused (Deductible and Coinsurance Costs) | Combined (No Cost for Wellness/Preventative Visit) (Deductible and Coinsurance Costs Apply to Problem-Focused Care) | Physical Exam (Deductible and Coinsurance Costs) (Medicare Does Not Cover Annual Physical) | |||
Review of Medical History, Wellness Services | ![]() | ![]() | ![]() | ||||
Health Risk Assessment Screenings | ![]() | ![]() | ![]() | ||||
Diagnostic Labs and Blood Tests | ![]() | ![]() | |||||
Discussion Of New or Chronic Conditions | ![]() | ![]() | |||||
Medication Refills | ![]() | ![]() | |||||
Acute Illness or Injury | ![]() | ![]() | |||||
Physical Exam Unrelated to Illness or Injury | ![]() |
*Service coverage will differ depending on your insurance, including Medicare and Medicare Advantage Plans. Please contact your insurance regarding what services are covered under your plan.