Medicare Annual Wellness Visit

Medicare began covering an Annual Wellness Visit with your primary care team effective January 1, 2011. There are no copays or deductibles for this visit.

Your first Annual Wellness Visit will include, among other things, your medical history, health risk assessment, evaluation of physical condition and screening for memory. In addition, your provider will work with you to set a prevention plan, including appropriate health screenings. If, after your visit, your provider determines additional testing is necessary, there may be a fee associated with some services.

Wellness Visit

Your health care team/provider should be someone who knows you as a person, not just a sick person. The Annual Wellness Visit is a strategy session designed to help you and your team or provider develop an ongoing health plan intended to keep you healthy, safe and independent for a long time.

The Annual Wellness Visit is not an annual physical, nor should it be confused with the "Welcome to Medicare Visit" - a one-time visit for patients new to Medicare.

Frequently Asked Questions

What does the Annual Wellness Visit cost?
You pay nothing out of pocket for this visit. You would only incur a copay or deductible expense if additional testing is required.

When am I eligible for my Annual Wellness Visit?
After you have had Medicare Part B for more than 12 months. If you've had a "Welcome to Medicare Visit" within the last 12 months, you must wait 12 months from that welcome visit to schedule your first Annual Wellness Visit.

What if I'm sick? Can I schedule my sick visit and Annual Wellness Visit at the same time?
It will depend on the severity of the illness and your provider's schedule but this may be possible. However, you will be charged for a sick visit at that time.

How often can I have my Annual Wellness Visit?
You may have an Annual Wellness Visit once every 12 months.

What is covered during the new Annual Wellness Visit?
Your first Annual Wellness Visit will include:

  • routine measurements such as height, weight, blood pressure and body mass index
  • review of medical and family history
  • establishing a list of current providers and medications
  • your personal risk assessment (including any mental health conditions)
  • a review of your functional ability and level of safety
  • screening of memory issues
  • screening for depression
  • establishing a schedule for Medicare's screening and preventive services you qualify for over the next five to 10 years
  • other advice or referral services that may help detect and treat potential health risks
  • voluntary advanced care planning

Is the Annual Wellness Visit the same thing as an annual physical exam?
No. An annual physical is a much more extensive physical examination. In addition to collecting your medical history, it may also include:

  • checking your vital signs
  • lung exam
  • head and neck exam
  • abdominal exam
  • neurological exam
  • skin exam
  • extremities exam

The Annual Wellness Visit should not replace your annual physical.

Will I actually see a provider during the Annual Wellness Visit?
Most of your time will be spent with an allied health professional, such as a nurse or medical assistant, who will gather most of your medical history. This will help your provider determine an appropriate health screening plan.

When am I eligible for my "Welcome to Medicare Visit?
Medicare covers a one-time "Welcome to Medicare Visit" within the first 12 months you have Medicare Part B. If you did not receive your Welcome to Medicare Visit and have been with Medicare for more than 12 months, you are eligible for your Annual Wellness Visit.

What does the Welcome to Medicare Visit cost?
Beginning January 2011, you pay nothing out of pocket for this visit.

What is covered in the "Welcome to Medicare Visit?"
A Welcome to Medicare Visit is similar to the Annual Wellness Visit and includes the following:

  • a thorough review of health, education and counseling about the preventive services covered by Medicare and referrals for other care if needed
  • establishing a schedule for Medicare's screening and preventive services you qualify for over the next five to 10 years
  • a review of your medical and social history with attention to risk factors for disease detection
  • a review of your potential for depression or other mood disorders
  • a review of your functional ability and level of safety
  • an examination to include height, weight, blood pressure, vision screen, measurement of body mass index and other factors as deemed appropriate by your health care team
  • end-of-life planning, upon your consent
  • education, counseling and referral based on the results of the review and evaluation services described in the previous components
  • EKG with interpretation and report
  • hearing assessment

What if I require further tests or screenings?
Medicare covers many screenings for people who are at high risk for certain diseases. During your Annual Wellness Visit, you and your provider will decide on the appropriate tests and screenings.

How do I schedule my Annual Wellness Visit or my Welcome to Medicare Visit?
Ask your primary care provider to help determine when you become eligible for your first Medicare Annual Wellness Visit.

For more information call 757-875-7880 or 800-675-6368, option 3.


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