A Guide to Your Medicare Annual Wellness Visit

Staying healthy isn’t just about treating illness; it’s about preventing it. That’s exactly what the Medicare Annual Wellness Visit is designed to do. If you’re enrolled in Medicare Part B and wondering how to take charge of your long-term health, this guide will walk you through everything you need to know.

We’ll cover what this visit includes, what it doesn’t, how often you can schedule one, and how to make the most of it. Whether you’re new to Medicare or already have Part B, the annual wellness visit is a key benefit worth understanding and using.

What Is a Medicare Wellness Visit?

Many people ask, “What is a Medicare wellness visit?”, and the answer is simple: it’s a yearly, no-cost service that supports long-term health planning, not diagnosis or treatment of current issues. A Medicare wellness exam is not a full physical but rather a preventive check-in to help you and your healthcare provider create a personalized plan for staying healthy. It includes a thorough review of your current health, potential risk factors, and preventive strategies to keep you well in the years ahead.

To qualify, you must have been enrolled in Medicare Part B for at least 12 months. It’s important to note that this visit is different from the “Welcome to Medicare” exam offered when you first enroll. 

What Happens During the Medicare Annual Wellness Visit?

Here’s what you can expect during your visit:

• Health risk assessment – You’ll complete a questionnaire about your lifestyle, daily activities, and general well-being.

• Review of medical and family history – Your provider will discuss chronic conditions, surgeries, and family history.

• Vital signs check – This includes blood pressure, height, weight, and Body Mass Index (BMI).

• Cognitive screening – A brief assessment for memory or thinking issues.

• Depression screening – Questions to identify signs of depression or emotional health concerns.

Using all this information, your provider will create a Personalized Prevention Plan (PPPS) tailored to your needs. This plan may include recommended screenings, vaccines, lifestyle changes, and referrals to other specialists. Care coordination is a core part of the visit, especially if you’re managing chronic illnesses or multiple medications.

What’s Not Covered by the Medicare Annual Wellness Visit?

While the Medicare annual wellness visit is a valuable service, it’s important to understand its limits. It does not include:

• A full physical exam

• Lab tests such as bloodwork or imaging

• Treatment for new or existing medical problems

If you need a diagnostic service during your visit, like a blood test or a discussion about a new symptom, it may result in out-of-pocket costs. To avoid surprises, it’s wise to ask your provider ahead of time what is included and what might trigger an additional charge.

How Often Can You Get a Medicare Annual Wellness Visit?

You’re eligible for a Medicare Annual Wellness Visit once every 12 months. This means your next visit must be at least 12 months after your last one.

There are two types of wellness visits:

• Initial wellness visit – Your first Medicare wellness visit after 12 months on Part B

• Subsequent visits – Annual follow-up visits to update your prevention plan

Both are covered under Medicare, but the timeline matters; be sure to track when your last visit occurred.

Medicare Coverage and Cost for the Wellness Visit

Good news: the Medicare annual wellness visit is covered 100% under Medicare Part B, as long as your provider accepts assignment. That means there’s no copay, no coinsurance, and no deductible for the visit itself.

However, if additional services are performed, like lab tests or treatment discussions, you may have to pay. That’s why it’s essential to understand your plan’s coverage or work with licensed agents like those at Unified Health to ensure you’re making full use of your benefits without unexpected costs.

How to Prepare for Your Wellness Visit

A little preparation can help you get the most out of your visit. Use this checklist to come prepared:

• Bring a list of current medications, including over-the-counter supplements.

• Write down family medical history, especially chronic conditions or genetic concerns.

• Note any health changes or concerns since your last visit.

• Bring records of vaccinations, screenings, or surgeries from the past year.

• Prepare questions about your health goals, preventive options, or chronic conditions.

You’ll get the most value from your visit when you come ready to engage in planning your future well-being.

Who Can Perform a Medicare Wellness Exam?

Only certain healthcare providers can conduct a Medicare wellness exam, including:

• Physicians (MDs or DOs)

• Nurse practitioners (NPs)

• Physician assistants (PAs)

• Clinical nurse specialists (CNSs)

To avoid unexpected charges, make sure your provider is in-network and accepts Medicare assignment. If you’re unsure, Unified Health can help you find a qualified provider near you.

Common Questions About the Medicare Annual Wellness Visit

Do I need to fast before my visit?

No, fasting isn’t necessary unless your provider has scheduled separate lab work.

Can I get lab work done at the same visit?

Lab work is not part of the wellness visit and may incur charges. It’s often scheduled separately.

What if I miss my yearly visit?

You can reschedule anytime after the 12-month mark from your last wellness visit.

Can I combine this with another appointment?

Yes, but be aware that combining visits, like a wellness exam and treatment consultation, might lead to additional billing.

Why the Medicare Annual Wellness Visit Matters

The Medicare annual wellness visit plays a vital role in keeping you healthy over time. By focusing on early detection, risk prevention, and personalized care plans, it helps you can manage chronic conditions before they become emergencies.

It’s especially valuable for patients on multiple medications or with long-term conditions. This annual check-in is a smart, proactive step toward better health outcomes.

After Your Wellness Visit

Once your visit is complete, take time to review the Prevention Plan provided by your healthcare provider. This plan may recommend several follow-up actions, such as:

• Scheduling screenings like mammograms or colonoscopies

• Starting a new nutrition or exercise routine

• Referrals to specialists for ongoing care

Make a habit of following through on these recommendations to maximize the long-term benefits of the visit.

Staying Ahead with Preventive Care

Taking advantage of your Medicare annual wellness visit is one of the easiest ways to stay proactive about your health. It’s a no-cost opportunity to work closely with a provider to identify risks, plan your care, and catch small issues before they become major concerns.

If you need help understanding your coverage or finding the right provider, Unified Health is here to guide you every step of the way.

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