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Good health doesn’t just happen. Be proactive to enjoy healthier, happier days. Start by scheduling your annual Medicare wellness exam. A WellMed primary care physician can help. Your Medicare wellness visit is an important check that offers a snapshot of your overall health. A Medicare wellness exam can help catch serious health issues early when they can be treated more easily. Your WellMed doctor will create a personalized prevention plan and connect you with preventive services covered by Medicare to help protect your health.

Medicare annual wellness visit requirements

“A Medicare annual wellness visit is a benefit of your Medicare coverage,” says Eseosa Eguae, MD. “You can schedule your annual Medicare annual wellness visit after you’ve had Medicare Part B coverage for at least 12 months. Best of all, there is no cost for the exam if you see a doctor who accepts Medicare. Your Part B Medicare coverage picks up the cost for your first Medicare annual wellness visit and every year afterward. Just make sure there are at least 365 days between each Medicare annual wellness visit.”

Keep in mind, you could have some out-of-pocket costs if your WellMed doctor needs to perform additional tests or services during your Medicare annual wellness visit that Medicare coverage doesn’t offer as a preventive benefit. Ask your WellMed doctor if you have any questions.

What is a Medicare wellness visit?

To help your Medicare primary doctor get a good snapshot of your overall health, the Medicare wellness visit includes several components. Together, they help your WellMed doctors put together a good picture of your physical and mental well-being. Just as important, each area of the Medicare wellness visit can highlight lifestyle risks or dangers. With this information, your WellMed doctor (who accepts Medicare and is a Medicare primary doctor) can create a personalized preventive plan to help you proactively address them. Are you’re wondering, “What is a Medicare wellness visit?” If so, here’s what you need to know about the different parts of the wellness visit.

  • Health risk assessment questionnaire: “This form offers a great opportunity for you to let your WellMed/Medicare primary doctor know important details about your health,” says Dr. Eguae. “If possible, fill it out ahead of your Medicare wellness visit. Be open and don’t be embarrassed to share your concerns.”
  • Routine measurements: “During your Medicare wellness visit, we’ll note your height, weight and blood pressure level,” adds Dr. Eguae. “As we track these stats from year to year, they offer insights into your health and well-being.”
  • Medical and family history: “Knowing what health conditions you’ve had in the past or are currently being treated factor into your personalized wellness plan,” says Dr. Eguae. “Since WellMed accepts Medicare, your WellMed doctor can help you understand any genetic connections you may have to certain health conditions.”
  • Medication review: “Your Medicare primary doctor needs to know every prescription and over-the-counter medication you take,” Dr. Eguae adds. “Including vitamins and other supplements. Often, they can interact in ways that may not be good for your health or with other medications you may take. At WellMed, all our doctors accept Medicare, so bring your medications with you when you see us for a Medicare wellness visit.”
  • Advance care planning: “A Medicare wellness visit is designed to gauge your present health and outline steps to protect it as long as possible, but it’s also about planning for your medical future,” notes Dr. Eguae. “All of us, at some point in our lives, will need serious care due to a chronic condition or serious illness. A Medicare primary doctor can help you start planning for that day. At WellMed, all our doctors accept Medicare, so we are happy to help you with your advance care planning.”
  • Cognitive assessment: “Early detection of cognitive issues ensures patients get the benefits of early treatment,” say Dr. Eguae. “They can be better prepared for their future. That’s why WellMed physicians, who are also Medicare primary doctors, look for signs of dementia or Alzheimer’s at every Medicare wellness visit.”

Frequently asked questions: Medicare wellness visits

What is included in a Medicare annual wellness exam?

During your Medicare annual wellness exam, your WellMed doctor will focus on making a personalized prevention plan to help keep you healthy. To create your plan, your WellMed doctor will gather some basic health information. You’ll be asked to fill out a “risk” questionnaire. During your visit, your WellMed doctor will:

  • Talk with you about your medical and family history
  • Log your height and weight
  • Take your blood pressure
  • Review all your prescriptions, vitamins and supplements
  • Check for signs of a cognitive conditions (dementia, Alzheimer’s)
  • Screen for signs of depression
  • Test your hearing
  • See if you’re at risk for falls

Your WellMed doctor will combine this data with your medical record to determine your risk for preventable health problems such as heart disease, cancer and type 2 diabetes. Based on your risks, your doctor will offer advice and a personal prevention plan with action steps and a checklist of health screenings.

What is not covered by a Medicare annual wellness visit?

If you’ve had Medicare Part B for at least 12 months, 100% of your Medicare annual wellness visit is covered when you see a doctor who accepts Medicare. All WellMed doctors in Texas and Florida are happy to accept Medicare. This means you pay nothing — no deductible or coinsurance — for your Medicare annual wellness visit. It’s important to remember that if your doctor discovers a new health problem that needs to be treated right away or treats you for an existing health issue during your Medicare annual wellness visit, there may be a cost to you. Diagnostic care and treatment are not covered as part of your Medicare annual wellness visit. Medicare may bill you for this care. You can discuss this with your doctor ahead of time.

What is the difference in a Medicare annual wellness visit and a physical exam?

A physical exam focuses on your current health. A Medicare annual wellness visit focuses on preventive care — proactive steps you can take to lower your risks of heart disease, cancer, type 2 diabetes and many other diseases. During a physical exam, your WellMed doctor performs “hands on” exams of your lungs, head and neck, abdomen and pelvic area. Your reflexes and vital signs are checked — along with neurological function. Urine and blood samples are collected for lab testing. As a rule, Medicare does not cover the costs for an annual physical. The exam and any tests your doctor orders are separate services. Depending on your Medicare plan, you may have out-of-pocket costs for a physical exam.

Why do Medicare wellness visits need to be 12 months apart?

For Medicare to pay for your annual wellness visits, they must be at least 365 days apart. The one-year intervals are designed to coordinate with many recommended annual health screenings. Checks for high blood pressure, diabetes, breast cancer and depression are a few examples.

Your first yearly Medicare wellness visit can’t take place within 12 months of your Part B enrollment or your welcome to Medicare preventive visit. However, you don’t need to have a Welcome to Medicare preventive visit to qualify for a yearly wellness visit.

Want to learn more about Medicare wellness visits? Read these articles.

Sources:

1. Staying Healthy as You Age: Medicare Annual Wellness Visits Explained. Mayo Clinic. https://www.medicare.gov/coverage/welcome-to-medicare-preventive-visit. Accessed June 2024.

3. Cognitive Screening and Assessment. Alzheimer’s Association. https://www.alz.org/professionals/health-systems-medical-professionals/cognitive-assessment. Accessed June 2024.

4. Annual Wellness Visit. Medicare Interactive. https://www.uhc.com/news-articles/medicare-articles/what-to-expect-at-your-annual-wellness-visit. Accessed June 2024.

6. What Doctors Wish Patients Knew About Medicare Annual Wellness Visits. American Medical Association. https://www.ama-assn.org/practice-management/medicare-medicaid/what-doctors-wish-patients-knew-about-medicare-annual. Accessed June 2024.