Each year you have Medicare coverage, you are eligible for an Annual Wellness Visit. The Medicare Annual Wellness Visit allows your doctor to assess your health and any new conditions you may be experiencing.
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While this is not a comprehensive visit, it is a good starting point for your physician to assess your health and how to treat you moving forward. In this article, we go over Medicare coverage of this appointment, what is not part of your visit, and how often you can receive this exam.
What is the Medicare Annual Wellness Visit?
When you have Medicare Part A and Part B for at least 12 months, you can receive a Medicare Annual Wellness Visit. This exam helps your physician review your personal healthcare plan to prevent major diseases or disabilities based on your risk factors.
The Annual Wellness Visit is not a physical exam, yet it helps check for signs of physical or mental abnormalities.
What is a Medicare Health Risk Assessment?
When you attend your 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:
- Personal and family medical history
- An up-to-date list of your medications
- Your current medical providers
- Current height and weight
- Possible risk factors and treatments
- Health advice
Once the Health Risk Assessment is complete, your physician will begin the Wellness Exam.
Medicare Wellness Exam Questions
During your Annual Wellness Exam, your physician will have a series of questions they need to answer to complete your exam.
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Below are some examples of what you may encounter:
- Blood pressure check
- Weight and height checks
- Immunizations
- Medication and supplement review
- Verbal screening for depression
- Counseling and health education
- Cognitive impairment (such as Alzheimer’s or dementia)
- Personal and family health history
- Health risk assessment
- Vision checks
What is Not Included in Your Visit?
The Medicare Annual Wellness Visit is not all-inclusive. Many procedures and tests are not part of this exam.
Here are some examples:
- Hands-on physical exam
- Any new health concerns
- X-rays
- Bloodwork
- Diagnosis or treatment of illnesses
- Any new medical issues
- Aches and/or wounds
- Substance and alcohol abuse screening
Medicare Coverage for My Annual Wellness Exam Visit
Medicare Part B outpatient coverage will pay for your Annual Wellness Visit. You should be aware that you must carry Medicare Part B for more than 12 months to qualify for this visit.
The Medicare Part B deductible does not apply to your annual wellness visit. If you qualify, Medicare will cover the visit at 100%.
Keep in mind, during your Annual Wellness Visit, your physician may review or treat a new or existing problem. This is considered additional care, which is diagnostic in nature.
This means your provider is treating you because of your symptoms or risk factors. Because of this additional service, you may be billed for diagnostic care received during your Annual Wellness appointment.
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?
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The Welcome to Medicare visit is a preventive appointment that you might receive when first joining Medicare. This is only once, within your first 12 months of Medicare Part B.
As discussed above, you receive the Medicare Annual Wellness exam when you have Medicare for more than 12 months. The appointment is once per year. The Annual Wellness Visit is a health evaluation, rather than a physical examination.
Furthermore, you can’t receive an Annual Wellness Visit during the same calendar year as your Welcome to Medicare preventive visit.
Can You Refuse Medicare Wellness Visit?
The Annual Wellness Visit is not mandatory. Thus, you can skip the appointment if you wish.
However, we recommend attending the free visit to allow your physician to assess your health and understand how to best care for you moving forward.
If you refuse the Annual Wellness Visit, your physician may perform the same services – and bill you – at a later appointment. So, it is wise to take advantage of the free exam!
How to Find Out More About the Medicare Annual Wellness Visit
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Dear Mr. Esch
Let me introduce myself I am a physician researcher that dedicated the last 6 years using advanced technology to develop a Real comprehensive Health Risk Assessment HRA instrument plus a complete AWV requiered Patient DATA
My understanding of this Congress. AWV plus latest HRA request Mandate to CMS real meaning is to assist Physician in Determining in an intelligent and scored way, what are the Health Risks that an interviewed Patient has to acquire or exacerbate a medical condition or to suffer a harmful Health event such as stroke or a fall . The outcome is determined trough an Algorithm technology of disease evidenced Risk Factors if the major Health conditions and Harmful event that affect our Senior population. In addition this technology done right will help Physician in providing a generated Personalized Preventive Plan with a complete evidenced Preventive recommendations to effectively assist Physician and their Patients to effectively cope with the HRA finding
Honestly a simple Questionnaire will really does not help the reason why and the Goal expected to improve the Patient Health and to prevent major issues along the line the AWV with a HRA as a center piece was instituted
Unfortunately today there are misunderstanding of the purpose of this magnificent HRA Health tool used in many other areas as banking and the industry
I decided to write my comments to you as an expert on this very important Health issues hope that wake up the conscious to do this right .
One last comment because of the lite questionnaires existing today on the market that are targeting the AWVHRA and the wrong concept to give Patient a simple HRA Questionnaire to take it home filled and returned for the AWV visit has been down graded and even under utilized by Physicians
Dear Mr Esch I asked my self as a physician what you will do with this so called HRA paper ? The same you do with the Questionnaires that a New patient fill out when come to see a Dr the first time.
I really hope my points reach your understanding about the great tool will mean this AWVHRA done right to really assist Physician in a better Plan of Care
Am I required to fill out the eight page form? Where does the information go other than the doctor’s office?