Doctor attending senior male patient using digital tablet
If you have Medicare Part B, you qualify for a free yearly wellness visit. This appointment is not the same as your regular check-up. In fact, it’s an opportunity to discuss your health goals in-depth and create a plan to maintain your highest quality of life over the long term.
A Medicare annual wellness visit, sometimes called a yearly wellness visit, is a review of your overall health. You discuss your health history and risks with your provider and develop a plan to improve your well-being. You may see a physician, an advanced practice provider (APP), clinical nurse specialist or other healthcare professional for your annual wellness visit.
A Medicare wellness visit is not a full physical exam. Your provider may record routine health metrics, such as your weight, height and blood pressure during this appointment. But most of your visit focuses on discussing your health risks and goals, administering preventive screenings and giving age-appropriate vaccinations as needed.
At an annual physical exam, your provider may order blood tests as needed.
Some Medicare Advantage plans cover both an annual physical exam and an annual wellness visit. If you have one of these plans, you will book these appointments separately.
To qualify for an annual wellness visit, you must have had Medicare Part B for 12 months or longer. You can schedule this visit annually at no cost.
Before scheduling your visit, you must ensure that it’s been at least 12 months since:
Your “Welcome to Medicare” visit is a free, optional appointment within your first 12 months of Medicare enrollment. It’s similar to an annual wellness visit.
During your annual wellness visit, you and your provider review your overall health. You discuss all the factors that affect your physical, mental and emotional well-being.
Your provider’s office may send you forms when you schedule your visit. Complete these forms before your appointment to maximize your time with your provider.
You should also gather some information to give to your provider:
It’s also a good idea to think about your health goals and needs. You may bring a list of questions you want to ask, such as:
The first part of your annual wellness visit is a health risk assessment (HRA). Some providers send you this HRA ahead of time, or you may complete it during your visit. Your HRA is a questionnaire that asks about your:
Your provider reviews your HRA and all the information you’ve brought to your appointment with you. They may also:
Next, you and your provider work together to develop a personalized prevention plan. This plan outlines the lifestyle changes, screenings or other preventive services you’ll need in the next five to 10 years. It may include:
You review and update this plan at each annual wellness visit.
As we age, our risk of health problems increases. Preventive care through an annual wellness visit can lower your risk of developing health problems.
It also increases the chances of diagnosing health conditions, such as cancer and chronic diseases, in early stages. Often, these conditions are easier to treat when you identify them early.
Regular wellness visits can also help with:
Inova Primary Care offices offer in-person visits. Schedule your Medicare annual wellness visit through:
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This a wonderful check up for me. What an exciting good news we have this and at no cost. We highly appreciate your taking care and giving this benefit to the aged retiree like me.
Please tell me how can I apply for this. Is my primary Dr. will be the one to give me this physical exam?
Thank you very much.
To qualify for an annual wellness visit, you must have had Medicare Part B for 12 months or longer. You can schedule the Medicare Annual Wellness in-person visit annually at no cost through:
Your MyChart patient portal
Online booking
Calling your doctor’s office
This is misleading and frustrating. I went for my annual wellness visit which lasted less than 20 minutes. I asked for prescriptions for my ongoing conditions and vaccines. I was charged for a subsequent visits. When I challenged this, the financial team stated that my HCP had "addressed" my chronic conditions etc. No detailed plan was discussed. This newsletter seems to encourage one to discuss all their needs at the wellness visit. But it seems it is only a way to get to charge for anything above the basic mini mental and vitals. I requested two times an explanation as to what was covered by the Medicare annual wellness and did not receive a response. This newsletter certainly does not jive with the fact that I was charged for myself bringing up that I needed new prescriptions. I am an HCP myself (PharmD) and know that my conditions were not addressed in detail, nor a big plan made- but Inova found a way to charge me for subsequent follow up,
Thank you for sharing your experience, we appreciate your feedback and the opportunity to provide some clarity.
Medicare’s Annual Wellness Visit (AWV) is designed to focus on preventive care, such as reviewing your medical history, assessing risk factors, and creating or updating a personalized prevention plan. However, it does not cover evaluation or management of chronic conditions, new symptoms, or prescription management those services may be billed separately under Medicare guidelines.
That said, we agree it’s essential that this distinction be clearly communicated. If you felt that your visit did not align with what was promoted or that you weren’t provided with a clear breakdown of what was and wasn’t covered, that is absolutely worth addressing.
For more detailed information on what Medicare covers during the Annual Wellness Visit, you can visit:
🔗 https://www.medicare.gov/coverage/yearly-wellness-visits
We also encourage you to follow up with the billing or patient relations department at your healthcare provider's office for further clarification. Transparency and respectful communication are vital, and your feedback may help improve the experience for others as well.
Thank you again for your thoughtful input.
Does this apply to patients who have Medicare B and TRICARE?
To qualify for a Medicare annual wellness visit, you must have had Medicare Part B for 12 months or longer, so you would qualify if you have both Medicare B and TRICARE coverage.
Please note that the the yearly “Wellness” visit isn’t a physical exam. If your health care provider performs additional tests or services during the same visit that Medicare doesn't cover under this preventive benefit then these tests and/or services would be billed to your secondary health plan, like TRICARE.
More information about what is included in a Medicare annual wellness visit can be found on Medicare's website: https://www.medicare.gov/coverage/yearly-wellness-visits