You may be asking yourself, what is a Medicare annual wellness visit? What will my doctor go over at this visit? What sort of outcomes can I expect from this appointment?
We’ll go over Medicare coverage of these appointments, what is and isn’t included in your visit, and the key factors that differ between an Annual Wellness Visit (AWV), Medicare preventative visit, and your welcome to Medicare visit.
What is the Medicare Annual Wellness Visit?
When you attend Medicare annual wellness visit, your physician will have you complete a “Health Risk Assessment”. This is a fancy term for a health questionnaire.
Completing this can help your physician come up with a tailored prevention plan.
Topics this questionnaire may include:
- both personal and family medical history
- an up-to-date list of current medications you’re taking
- current providers, you’re seeing
- current height and weight
- possible risk factors and treatments
- health advice
Medicare Coverage For My Annual Wellness Exam Visit
Your annual visit coverage is under your Medicare Part B. You should be aware that you must carry Medicare Part B for more than 12 months to qualify for this visit.
The Part B deductible doesn’t apply to your annual wellness visit.
If you qualify, Medicare will cover the AWV at 100% of the Medicare amount when services come from a participating provider.
During your AWV appointment, your physician might find a need to review or treat a new or existing problem. This is considered additional care and would be considered diagnostic.
This means your provider is treating you because of your symptoms or risk factors. You may be billed for diagnostic care received during your AWV because of this additional service.
Welcome to Medicare Visit vs Medicare Annual Wellness Visit
While these two exams have many similarities, they carry some differences. What is the main difference between a Welcome to Medicare Preventative Visit and a Medicare Wellness Visit you might ask? The Welcome to Medicare visit is a preventative appointment that you might receive when first joining Medicare. This is only once, within your first 12 months of Part B.
As discussed above, the Medicare Annual Wellness Visit is an exam that you receive if you’ve been a Medicare recipient for more than 12 months, and this appointment is once per year. This is more of overall health evaluation, rather than a physical examination.
Furthermore, you can’t receive an AWV during the same calendar year as your Welcome to Medicare preventative visit.
Are Wellness Visits and Physical Exams the Same Thing
While both examinations are of great importance, annual physical exams are very different from annual wellness visits.A physical exam can include some of the components of the wellness visit (vitals check, neurological assessment), but not all. These appointments may include abdominal assessments, head and neck exams, lung exams, heart assessments, etc.
AWVs are great for Advance Care Planning and Directives, checking one’s level of safety and cognitive function, and overall health and general appearance.
What’s Included in your Annual Wellness Visit
Preparing for a visit can be overwhelming especially when you don’t know what to expect at your annual visit. For the most part, the doctor goes over standard wellness checks.
Below are some examples of what you may encounter:
- Blood pressure check
- Weight and height checks
- Medication & supplement review
- Verbal screening for depression
- Counseling and health education
- Cognitive Impairment (such as Alzheimer’s or dementia)
- Personal and family health history
- Review of your level of safety and functional ability
- Vision checks
What’s Not Included in Your Visit
Since this is a pretty hands-off appointment, you’ll have quite a few procedures and tests that won’t be included in your annual visit (safe to say anything that leans more on the physical side). Let’s take a look at some of those examples below:
- Hands-on physical exam
- Any new health concerns
- Diagnosis or treatment of illnesses
- Any new medical issues
- Aches and/or wounds
Are Annual Visits Mandatory
Is your Part B coverage dependent upon attending your AWV? While there are plenty of benefits in scheduling your annual visit with your doctor, it’s not a requirement. The benefits of attending your annual visit do seem to far outweigh those of not attending. Early detection of illness or disease is always great when it comes time to go over treatment options.
What to Bring to the Visit
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