Dear Marci,
When I last visited my doctor, she said that we should schedule my Annual Wellness Visit soon to discuss my health. I have never had an Annual Wellness Visit before, and I am not sure what this visit is about. Is it just a regular physical exam? What happens during an Annual Wellness Visit?
– Jackie (Lexington, KY)
Dear Jackie,
The Annual Wellness Visit is an annual appointment with your primary care doctor to develop your plan of preventive care for the upcoming year. This visit is not a head-to-toe physical; rather, it is an opportunity to discuss your current health with your doctor and create a plan for promoting your health and wellness. The Annual Wellness Visit is similar to your Welcome to Medicare visit, the one-time appointment with your doctor that takes place within the first twelve months after you enroll into Medicare. Know that you cannot have your Annual Wellness Visit within the same year that you have your Welcome to Medicare exam.
Since this will be your first Annual Wellness Visit, you and your doctor will create a prevention plan based on your needs. You will likely discuss your medical and family history, complete a health-risk assessment that considers your health status, injury risks, and any health needs, and compile a list of all of your current medical providers and medications. You can start to consider these things in advance of your appointment to prepare for the visit.
Depending on your health care needs and history, you and your doctor might do any of the following tasks during your Annual Wellness Visit:
- Create a checklist or screening schedule for various preventive health care screenings. Medicare covers many preventive care services, and this checklist will depend on your health status and what services you are eligible to receive;
- Identify risk factors and current medical and mental health conditions along with related current or recommended treatments;
- Check your height, weight, blood pressure, and body mass index;
- Screen for cognitive impairment, including diseases such as Alzheimer’s or other forms of dementia;
- Review risk factors for depression;
- Review your functional ability and level of safety, including screening for hearing impairments and for your risk of falling; or
- Give health advice and referrals to education or preventive counseling services or programs aimed at reducing identified risk factors and promoting wellness, such as weight loss, physical activity, smoking cessation, fall prevention, and nutrition.
You will not have a full physical as part of your Annual Wellness visit. Rather, the visit is used to assess your overall state of health and put a plan in place to maintain and promote your well-being.
Original Medicare covers the Annual Wellness Visit with no coinsurance or deductible as long as you see doctors or other health care providers who accept Medicare assignment. Medicare Advantage plans cover all preventive services the same as Original Medicare, so your plan is not allowed to charge cost-sharing fees (coinsurances, copays or deductibles) for preventive services that Original Medicare does not charge for as long as you see in-network providers. If you see providers that are not in your plan’s network, charges will typically apply.
It’s very important to keep in mind that, while the Annual Wellness visit itself is free, out of pocket costs can apply for additional care you receive during or following the visit. If your primary care provider explores or treats a new or existing health issue or runs test separate from those listed above during the Annual Wellness Visit, you may be charged. Services not included in the Annual Wellness Visit are billed separately and are subject to the usual copays and deductibles.
-Marci