Medicare Annual Wellness visits

If you’ve had Medicare Part B (Medical Insurance) for longer than 12 months, you can get a yearly “Wellness” visit to develop or update your personalized plan to help prevent disease and disability, based on your current health and risk factors. The yearly “Wellness” visit isn’t a physical exam.

You pay nothing for this visit and the Medicare Part B deductible does not apply. However, you may have to pay coinsurance, and the Part B deductible may apply if additional tests or services are performed during the same visit and medicare doesn't cover these additional tests or services under this preventive benefit.

What is a wellness visit?

You will be asked to fill out a questionnaire, called a “Health Risk Assessment,” as part of this visit. Answering these questions can help you and your provider develop a personalized prevention plan to help you stay healthy.

Your visit may include a review of your medical and family history, your current providers and prescriptions, height, weight, blood pressure, and other routine measurements. Your provider will also provide personalized health advice and advise what risk factors and treatment options are available to you. This appointment is also an opportunity to discuss your screening schedule (like a checklist) for appropriate preventive services and get details about coverage for screenings, shots, and other preventive services.

As part of advance care planning your provider will also perform a cognitive assessment to look for signs of dementia, including Alzheimer’s disease. Signs of cognitive impairment can include trouble remembering, learning new things, concentrating, managing finances, and making decisions. If your provider thinks you may have cognitive impairment, Medicare covers a separate visit to do a more thorough review of cognitive function and check for conditions like dementia, depression, or anxiety.

Note:

If you have a current prescription for opioids, your provider will review your potential risk factors for opioid use disorder, evaluate your severity of pain and current treatment plan, provide information on non-opioid treatment options, and may refer you to a specialist, if appropriate. Your provider will also review your potential risk factors for substance use disorder and refer you for treatment, if needed.

https://www.medicare.gov/coverage/yearly-wellness-visits