Medicare Annual Wellness

What is a Medicare Annual Wellness Visit?

  • 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.

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