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What Is the Medicare Annual Wellness Visit?

Medicare Wellness Visits and annual physicals are different. Learn more about what the Medicare Annual Wellness Visit includes and who qualifies for a visit each year.

 

Your Medicare Annual Wellness Visit (AWV) is an essential component of preventive healthcare. These visits aim to promote health and well-being, while identifying potential health risks early on in your time as a Medicare beneficiary.

In this guide, we'll explain how a Medicare Annual Wellness Visit is different form a routine physical exam, we'll detail why your Medicare AWV is important and we'll explore how you may be able to find a Medicare Advantage plan that covers benefits that Original Medicare doesn't cover.

Medicare Wellness Visit vs. Annual Physical

Medicare Wellness Visits and annual physicals are different in a few key ways. Original Medicare (Part A and Part B) covers the Annual Wellness Visit, but it doesn't cover routine physical exams, though some Medicare Advantage plans may cover this type of preventive care.

  • Your Medicare Annual Wellness Visit is part of the preventive health services covered by Medicare that help create or update your unique and personalized prevention plan to help you stay healthy.

    Medicare Annual Wellness Visit utilization focuses on your overall well-being and aims to identify any potential health risks before they become serious issues. Medicare also covers advance care planning as part of the annual wellness visit.

  • A routine physical exam is something you go through with your doctor or other primary care providers who can diagnose and potentially treat any existing health conditions you may have at the time.

    A routine physical typically includes blood tests, which your Medicare Annual Wellness Visit does not include.

The annual visit was introduced as part of the Affordable Care Act, with the goal of encouraging more proactive healthcare for older adults. It differs from a traditional physical exam in that it emphasizes prevention and planning rather than diagnosing existing conditions.

  • Detection: The visit includes screenings for early signs of chronic diseases such as diabetes, heart disease and certain cancers.

  • Evaluation: Your healthcare provider will assess your risk factors based on your medical history, lifestyle choices and family background. From this, a health risk assessment will be made. 

  • Action Plan: Together with your doctor or nurse practitioner, you'll develop a primary care strategy for maintaining good health through regular checkups, vaccinations, exercise routines, dietary changes if needed, etc., depending on individual needs/preferences.

This comprehensive approach allows both patients and providers alike access to valuable information regarding one's current state while also providing guidance moving forward towards healthier futures.

Who Is Eligible for Medicare Wellness Visits?

All Medicare beneficiaries are eligible for Annual Wellness Visits and an initial "Welcome to Medicare" visit

To be eligible for this health risk assessment, you must meet the following criteria:

  • Have had Medicare insurance for more than 12 months
  • Not have received an Initial Preventive Physical Examination (IPPE) or "Welcome to Medicare" preventive visit within the past 12 months

The IPPE is a one-time introductory visit offered during the first year of enrollment in Medicare. It serves as a baseline assessment of your health status and helps establish future care plans. After receiving the IPPE, beneficiaries become eligible for visits every subsequent year.

If you're unsure about your eligibility or when your last wellness visit occurred, contact your healthcare provider or call 1-800-MEDICARE.

What if I Have Recently Applied for Medicare Enrollment?

New enrollees who have not yet completed their first year may still benefit from preventive services through the aforementioned IPPE.

This comprehensive evaluation includes many elements similar to those found in the annual physical but focuses on introducing new beneficiaries to available resources and establishing initial care plans.

What Does an Annual Wellness Visit Include?

A Medicare Annual Wellness Visit includes a review of your medical and family history, a measurement of certain health vital signs, a review of your current prescription drugs and a personalized review of your health plan.

Review of Medical and Family History

Your healthcare professional will commence by analyzing your medical annals, containing prior diseases, operations and medications. Your healthcare provider will also inquire about your family's medical history to identify any hereditary conditions or potential risk factors. 

It's crucial to be open with your doctor about all aspects of your health during this discussion.

Vital Measurements

During the visit, various measurements such as height, weight and blood pressure will be taken. These vital statistics can help identify trends in growth or changes in weight that may indicate underlying issues requiring further investigation.

Screening Tests

A variety of screening tests may be conducted during the wellness visit depending on individual needs and risk factors identified through discussions with the healthcare provider. Some common screenings could include:

  • Vision tests to check for eye problems like glaucoma or cataracts
  • Hearing tests to assess hearing loss which might require intervention
  • Cognitive assessments to screen for early signs of dementia or memory impairment

Conclusion

An Annual Wellness Visit is a free yearly appointment that Medicare beneficiaries can take advantage of to stay on top of their health, but it's not the same thing as a routine physical exam. During the visit, individuals can talk with their health care professional about past and present medical issues to develop a tailored plan for prevention.

To be eligible for an Annual Wellness Visit, you must have had Medicare Part B for at least 12 months and not have had an Initial Preventive Physical Examination (IPPE) or "Welcome to Medicare" preventive visit within the past 12 months.

About the author

Profile Image of Matt Clements, Senior Editor

Matt Clements

Matt Clements is the Senior Editor and Content Manager with MedicareMatch. He specializes in health industry research and informational content related to Medicare, Medicaid, retirement benefits and other vital but complicated topics.

His research has been featured by news outlets including Forbes, MarketWatch, Yahoo! Finance and more.

A current resident of Raleigh, Matt is a graduate of the University of North Carolina with a bachelor’s degree in English.

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Welcome to the first step in your Medicare Advantage journey.

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