Take Advantage of Your Annual Wellness Visit

April 10, 2014 Providence Health Team

Did you know Medicare covers an Annual Wellness Visit in addition to the one-time “Welcome to Medicare” exam? The “Welcome to Medicare” exam occurs only once during your first 12 months as a Medicare patient. You may receive your Annual Wellness Visit after you have been with Medicare for more than one year, or if it has been at least one year since your “Welcome to Medicare” exam.

The Annual Wellness Visit is not the same thing as what many people often refer to as their yearly physical exam. Medicare is very specific about what the Annual Wellness Visit includes and excludes.

At the Annual Wellness Visit, your doctor will talk to you about your medical history, review your risk factors and make a personalized prevention plan to keep you healthy.

The yearly Annual Wellness Visit is allowed every year; just remember it needs to be 1 year + 1 day from your last one. This might be something you want to do the month of your birthday.

Medicare Annual Wellness Visit Includes:

  • Review of your family, social and medical history
  • Review of your medications and allergies
  • Update on your care team, including:
    - Specialists
    - Pharmacies
    - Medical suppliers
  • Vital signs measurement
  • Depression screening
  • Functional ability and safety screening
  • Cognitive function assessment
  • Risk factor review
  • A plan for preventive/screening schedule for 5-10 years
  • Advanced directives discussion

Medicare Annual Wellness Visit Does Not Include:

  • A hands-on exam
  • Any testing or lab work your doctor may recommend
  • Discussion about any new or current medical problems, conditions or medications.

You may schedule another visit to address those issues or your doctor may charge the usual Medicare fees for such services that are beyond the scope of the Annual Wellness Visit.

Required Paperwork

When you call your provider’s office to schedule an appointment, please let them know it is for the Annual Wellness Exam that Medicare offers. You will need to pick up two forms to fill out ahead of time or arrive 30 minutes early to fill out the paperwork:

  • Annual Wellness Form
  • Health Risk Assessment

Frequently Asked Questions

Who may perform the Annual Wellness Visit?

A health professional, meaning a physician (a doctor of medicine or osteopathy), a qualified non-physician practitioner (a physician assistant, nurse practitioner or certified clinical nurse specialist), a medical professional (including a health educator, registered dietitian, nutrition professional or other licensed practitioner) or a team of such medical professionals who are working under the direct supervision of a physician, must perform the AWV.

Is the Annual Wellness Visit the same as a beneficiary’s yearly physical?

No, the Annual Wellness Visit is a preventive wellness visit and is not a “routine physical checkup” that some seniors may receive every year or two from their physician or other qualified non-physician practitioner. Medicare does not cover routine physical examinations.

Are clinical laboratory tests part of the Annual Wellness Visit?

No, the Annual Wellness Visit does not include any clinical laboratory tests, but your health care provider may want to make referrals for such tests as part of the Annual Wellness Visit, if appropriate.

Do deductible or coinsurance/copayments apply for the Annual Wellness Visit?

No, coverage for the Annual Wellness Visit is provided as a Medicare Part B benefit. Medicare waives both the coinsurance or copayment and the Medicare Part B deductible for the Annual Wellness Visit.

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