Information for Medicare Patients about the Annual Wellness Visit.
Physical Exam or Wellness Visit? What Medicare Covers
Posted by Medicare Made Clear
The following information comes directly from Medicare.gov:
Yearly “Wellness” visits: If you’ve had Part B for longer than 12 months, you can get this visit to develop or update a personalized prevention help plan to prevent disease and disability based on your current health and risk factors. Your provider will ask you to fill out a questionnaire, called a “Health Risk Assessment,” as part of this visit. Answering these questions can help you and your provider develop a personalized prevention plan to help you stay healthy and get the most out of your visit. It also includes:
– A review of your medical and family history
– Developing or updating a list of current providers and prescription
– Height, weight, blood pressure, and other routine measurements
– Detection of any cognitive impairment
– Personalized health advice
– A list of risk factors and treatment options for you
– A screening schedule (like a checklist) for appropriate preventive services. Get details about coverage for screenings, shots, and other preventive services.
This visit is covered once every 12 months (11 full months must have passed since the last visit).
All people with Medicare are covered for the AWV.
Your costs in Original Medicare
You pay nothing for the “Welcome to Medicare” preventive visit or the yearly “Wellness” visit if your doctor or other qualified health care provider accepts assignment. The Part B deductible doesn’t apply.
However, if your doctor or other health care provider performs additional tests or services during the same visit that aren’t covered under these preventive benefits, you may have to pay coinsurance, and the Part B deductible may apply.
Read an article about this benefit on USNews.com.
Note: Your doctor or other health care provider may recommend you get services more often than Medicare covers. Or, they may recommend services that Medicare doesn’t cover. If this happens, you may have to pay some or all of the costs. It’s important to ask questions so you understand why your doctor is recommending certain services and whether Medicare will pay for them.