What is Medicare?

Medicare is a federal program that provides health coverage
if you are 65+ or under 65 and have a disability, no matter
your income.

What is an Annual Medicare Wellness Visit?

The term “physical” is often used to describe wellness care,
but your Annual Wellness Visit is not a traditional, head-to-
toe physical. Rather, it is an opportunity for you and your
doctor to discuss any current risk for illness and injury and
develop a plan of action for future medical care. The goal is
to help you live a healthier life.
Wellness Visits are covered under Medicare Part B. You can
get one visit every 12 months. There is no cost for the visit
itself. You may have some costs if your doctor recommends
or performs additional services during the visit.

Who is eligible for an Annual Medicare
Wellness visit?

• Enrolled in Medicare Part B for more than 12 months
• Have not received an Annual Wellness Visit in the past 12
  months

What to expect from your Wellness Visit

Your primary care team will develop your personalized
prevention plan which may include health advice and referrals
to health education and/or preventive counseling services
aimed to promote wellness.

What is not covered at an Annual Medicare Wellness Visit?

A Wellness Visit does not address new or existing health problems. Those concerns and issues require a different appointment where a separate charge will apply.

If your doctor recommends additional preventive screenings or tests, be sure that you understand how often these are covered and what your share of the cost may be before you have them. You may need your doctor’s referral/ recommendation for certain services to be covered.

What you should bring to your Wellness Visit

The more organized and prepared you are for your visit, the more time you and your doctor may have to discuss your health. It’s a good idea to gather the following to take with you to your appointment:

• All medication you take (prescription, non-prescription, vitamins, supplements, and herbal); it may be easiest to put the bottles in a bag and take them with you
• A list of all health care providers you see, including names and contact information.
• Your completed health history form and health risk assessment if sent to you by your doctor’s office ahead of time
• A list of questions or things you want to discuss with your doctor

Costs

Yearly Wellness Visit- Preventive Service Yearly Wellness Visit
If you’ve had Part B for longer than 12 months, you can get a yearly Wellness Visit to develop or update your personalized plan to prevent disease or disability based on your current health and risk factors. The yearly Wellness Visit isn’t a physical exam. Medicare covers this visit once every 12 months.

NOTE: Your first yearly 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 had a “Welcome to Medicare” Preventive Visit to qualify for a yearly Wellness Visit. You pay nothing for the yearly Wellness Visit if the doctor or health care practitioner accepts assignment.

If your doctor or health care practitioner performs additional tests or services during your Wellness Visit that Medicare doesn’t cover under this preventive benefit, you may have to pay a coinsurance, and the Part B deductible may apply. If Medicare doesn’t cover the additional tests or services (like a routine physical exam), you may have to pay the full amount.

For more information visit: Medicare and You Handbook 2024