What is the Medicare Annual Wellness Visit?
Medicare’s annual wellness visit is a preventative care service provided to Part B beneficiaries at no cost. The annual wellness visit is available every twelve months after the beneficiary’s initial Welcome to Medicare preventative visit.
Key Takeaways
- The annual wellness visit is a preventative care service that reviews the beneficiary’s health history and helps make a health plan for the future.
- Annual wellness visits are not mandatory to maintain Part B coverage.
- The annual wellness visit is covered by Medicare Part BMedicare Part B is medical coverage for people with Original Medicare benefits. It covers doctor visits, preventative care, tests, durable medical equipment, and supplies. Medicare Part B pays 80 percent of most medically necessary healthcare services..
- Beneficiaries should bring any updates to their health history to their annual wellness visits.
- Annual wellness visits are not the same as the Welcome to Medicare visit, a complimentary wellness exam for newly enrolled Part B beneficiaries.
What Happens During the Medicare Annual Wellness Visit?
The beneficiary’s healthcare provider will ask them to complete a questionnaire called a Health Risk Assessment. This will help their healthcare provider create a personalized prevention plan that will help the beneficiaryA person who has health care insurance through the Medicare or Medicaid programs. to keep themselves as healthy as possible each visit. The annual wellness visit also includes:1Medicare.gov, “‘Yearly ‘Wellness’ visits“, Accessed October 27, 2021
- A review of the beneficiary’s medical and family history.
- Developing or updating a list of current providers and prescriptions.
- 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 the beneficiary.
- A screening schedule (like a checklist) for appropriate preventive services.
- Advance care planning
Is the Medicare Annual Wellness Visit Mandatory?
Beneficiaries are not required to attend an annual wellness visit and will not be penalized for declining it. However, it is a free check-up and covers a lot of preventative care services in each visit.1Medicare.gov, “‘Yearly ‘Wellness’ visits“, Accessed October 27, 2021
The Cost of an Annual Wellness Visit
The annual wellness visit is fully covered by Part B as long as the beneficiary does not require any other health care services during the visit. If the beneficiary requests additional services not covered by the annual wellness visit, Part B coinsurances may apply. While the beneficiary will not pay anything for the annual wellness visit, the visit will not count to their Part B annual deductibleA deductible is an amount a beneficiary must pay for their health care expenses before the health insurance policy begins to pay its share. either.1Medicare.gov, “‘Yearly ‘Wellness’ visits“, Accessed October 27, 2021
What to Bring to the Annual Wellness Visit?
If there are changes to a beneficiary’s health history since their last annual wellness visit, it will help to bring information on these changes to their annual wellness visit. Examples include:2Medicare.gov, “‘Welcome to Medicare’ preventative visit“, Accessed October 27, 2021
- Medical records, including immunization records
- Family health history
- A list of any drugs and supplements currently taken
Annual Wellness Visits and the Welcome to Medicare Visit
The Welcome to Medicare visit is a similar but distinct service from Medicare’s annual wellness visits. The Welcome to Medicare visit is available within the first twelve months of enrolling in Medicare Part B. The visit establishes the beneficiary’s current health history, providing much of what is covered by the annual wellness visits along with additional services:2Medicare.gov, “‘Welcome to Medicare’ preventative visit“, Accessed October 27, 2021
- Certain screenings, flu and pneumococcal shots, and referrals for other care, if needed.
- Height, weight, and blood pressure measurements.
- A calculation of the beneficiary’s body mass index (BMI).
- A simple vision test.
- A review of the beneficiary’s potential risk for depression and their level of safety.
- An offer to talk with the beneficiary about creating advance directives.
- A written plan letting the beneficiary know which screenings, shots, and other preventive services they need.
Like the annual wellness visit, the Welcome to Medicare visit requires no coinsuranceCoinsurance is a percentage of the total you are required to pay for a medical service. from the beneficiary unless additional services are requested.2Medicare.gov, “‘Welcome to Medicare’ preventative visit“, Accessed October 27, 2021
Citations
- 1Medicare.gov, “‘Yearly ‘Wellness’ visits“, Accessed October 27, 2021
- 2Medicare.gov, “‘Welcome to Medicare’ preventative visit“, Accessed October 27, 2021