Understanding Your Medicare Annual Wellness Visit

By on August 22, 2018
Understanding Your Medicare Annual Wellness Visit

By Christian Worstell—

Worldwide, people are living longer than the generations before them did. In fact, data from a United Nations report shows that the number of people age 65 and older rose from eight percent to 12 percent of the total population between the year 1950 and the year 2000.1

Part of living longer is not only treating medical conditions as they occur, but taking the necessary preventive steps to avoid them altogether. This can be even more important as you age and become more susceptible to certain ailments and conditions. 

Medicare emphasizes preventive care by providing cost-free Annual Wellness Visits that can help catch signs of disease early.

What Is the Medicare Annual Wellness Visit?

The Medicare Annual Wellness Visit is a yearly visit with your doctor where the two of you create or update a personalized health care plan tailored to your specific health care needs. 

Some examples of services you may receive at your Annual Wellness Visit include:

  • A review of your medical and family history
  • Body mass index calculation
  • Height, weight and blood pressure measurements
  • Advance care planning
  • A review of the medications, supplements and vitamins you are currently taking
  • A screening schedule for appropriate preventive services

Generally, your doctor will determine which screenings are appropriate for you based on factors such as your age, gender, personal health history, current symptoms and overall health status.2 

The Annual Wellness Visit won’t typically evaluate your vision or your dental health. Some Medicare Advantage plans – such as those offered by private insurers such as Humana – may offer some vision and dental benefits that could include vision and dental checkups.

To learn more about what the Wellness Visit covers, read more here.

Who’s Eligible for the Medicare Annual Wellness Visit?

The Medicare Annual Wellness Visit is covered by Medicare Part B, which means you must be enrolled in Part B to take advantage of this benefit. 

You are generally eligible for a Medicare Annual Wellness visit if:

  • You have been enrolled in Medicare Part B for 12 months or longer
  • You have not received an annual wellness visit within the past 12 months
  • You have not received your Welcome to Medicare Visit in the past 12 months

If you meet the above qualifications, you are typically eligible for an Annual Wellness Visit at no cost (if your healthcare provider accepts Medicare assignment). 

Why You Should Take Advantage of the Annual Wellness Visit

As we age, our bodies go through significant changes that can require more care and attention.

For example, osteoporosis is a condition commonly found in older adults in which the bones become weak and brittle. Several factors can increase your risk of developing osteoporosis, such as your age, gender, ethnicity and family history of the disease.3

If your doctor determines that you are a high risk for developing osteoporosis, he or she can use your Annual Wellness Visit to develop a health care plan that may include monitoring your bone density and/or managing your osteoporosis symptoms to avoid further bone damage. 

Of course, osteoporosis is just one example of the types of conditions that your Medicare Annual Wellness Visit can help you prevent or manage. 

Other medical conditions related to aging can include:

  • Adult onset diabetes
  • Arthritis
  • Dementia
  • Parkinson’s disease
  • Cataracts
  • Lung disease
  • Glaucoma
  • Cardiovascular disease

The better your doctor gets to know your medical history and current health status, the more effectively the two of you can plan your personalized health care plan to prevent diseases like those listed above. Going to your Annual Wellness Visit every year is a simple way to take control of your health.

4 Things to Know Before You Book Your Appointment

To ensure you go into your Annual Wellness Visit informed, here are a few tips to help you get the most from your appointment. 

1. The Medicare Annual Wellness Visit is not the same as your Welcome to Medicare Visit

You are eligible for a Medicare Annual Wellness visit every year as long as you’re enrolled in Medicare Part B. 

The Welcome to Medicare visit occurs only once and must be used within the first 12 months of you enrolling in Medicare Part B. 

At your Welcome to Medicare Visit, your doctor will likely:

  • Evaluate your medical and family history, current health conditions and prescriptions
  • Check your blood pressure, weight, height and vision
  • Make sure you’re up to date on your preventive screenings and services
  • Order further tests if necessary

The Annual Wellness Visit offers services that are not included in the Welcome to Medicare Visit, such as the opportunity to develop a personalized prevention plan. 

2. You could end up paying a copay 

Although the Medicare Annual Wellness Visit is a free preventive visit, you could end up paying a copayment or coinsurance if your doctor treats you for a condition during the visit. 

When you schedule your appointment, be sure to specify that you are coming in for the Medicare Annual Wellness visit and confirm that you will not be charged any cost-sharing for the wellness visit. 

If your doctor recommends any treatment services or tests at your wellness visit, be sure to ask him or her if the services are cost-free under the wellness visit. If they aren’t, ask them how much you will likely have to pay out of pocket for the services. 

3. Bring your ID and Medicare card to your appointment

As with any doctor’s visit, you’ll need to present your ID and Medicare card. Your Medicare card is usually sent to you in the mail three months before you turn 65 (if you’re automatically enrolled in Medicare) and within a few months of signing up for Medicare (if you manually enroll). 

If you’re enrolled in Medicare Advantage, you’ll receive a Medicare Advantage card in the mail in addition to your Original Medicare card. If you have Medicare Advantage, your Medicare Advantage card is generally the card you’ll show your health care provider when you go in for your visit. 

4. Find out if your health care provider accepts assignment

Doctors who accept Medicare assignment agree to accept the Medicare-approved amount as full payment for covered services. 

Doctors who do not accept Medicare assignment can charge up to 15 percent more than the Medicare-approved amount for a covered service. 

If you go to a doctor who does not accept assignment, your Medicare Annual Wellness visit may not be covered 100 percent by Medicare, which means you could be responsible for some out-of-pocket costs, even just for preventive services. 

Before you schedule your Medicare Annual Wellness Visit, ask your health care provider if they accept Medicare assignment. If they don’t, you may consider visiting a physician who does, to avoid paying higher out-of-pocket costs.  

Your Annual Wellness Visit gives you the chance to take charge of your health and live a healthier life. Don’t miss out — schedule your wellness visit today!

1 https://gerontology.usc.edu/resources/infographics/americans-are-living-longer/

2 https://www.medicare.gov/coverage/preventive-visit-and-yearly-wellness-exams.html

3 https://www.nof.org/patients/diagnosis-information/bone-density-examtesting/


Christian Worstell is a freelance writer who lives in Raleigh, NC. He writes about health, travel and lifestyle topics and is a frequent contributor to MedicareAdvantage.com.

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Understanding Your Medicare Annual Wellness Visit