The Medicare wellness exam, or Annual Wellness Visit (AWV), provides an annual opportunity for Medicare beneficiaries to create or update their personalized prevention plan.
This exam is part of an effort by Medicare to encourage seniors to be proactive about their health and engage more in preventive health services.
Your Medicare Annual Wellness Visit is different from your initial Welcome to Medicare doctor’s office visit.
During the first 12 months of being enrolled in Medicare Part B, you may participate in the Welcome to Medicare visit. The appointment is covered in full by Medicare, as long as it is performed by a doctor who accepts Medicare assignment.
This appointment will include a review of your medical history, and your doctor will conduct a variety of health assessments, which can include:
Based on the results, your doctor will then formulate a written personalized prevention plan for you. This personal plan will detail which preventive services and screenings are recommended for you, along with advice on your diet, lifestyle and overall well-being.
Your doctor will also offer to speak to you about creating advance directives. An advance directive is a legal document that you write to determine how you would want your health care to be administered if you were unable to speak for yourself.
Once you have a baseline of your health established by your Welcome to Medicare exam, you may then return to your doctor each year for your Annual Wellness Exam.
Note: you are not required to attend a Welcome to Medicare visit in order to be covered for your Annual Wellness Visit.
Your Medicare Annual Wellness exam serves as a regular follow-up to assess any changes in your health over the previous year and track the progress of your personalized prevention plan.
You will be asked to fill out a “Health Risk Assessment,” which includes a series of questions about your health, diet and lifestyle.
Your Annual Wellness Visit will also include many of the routine procedures performed in the “Welcome to Medicare” visit, such as checking your weight and blood pressure.
During your Annual Wellness Visit, your provider will provide a number of health care services, such as:
Just like the “Welcome to Medicare” exam, the Annual Wellness Visit is covered in full by Medicare, as long as your doctor accepts Medicare assignment.
Although the visit is covered in full, there may be costs to you if your doctor orders additional tests or performs services not covered by Medicare’s preventive benefits.
Some potential out-of-pocket Medicare costs you may face for covered services include the Medicare Part B deductible ($198 per year in 2020) and the Part B copay/coinsurance, which is typically 20 percent of the Medicare-approved amount for covered services.
If you have Original Medicare, you can consider applying for a Medicare Supplement Insurance (Medigap) plan. Medigap plans can help pay for a number of Medicare out-of-pocket costs, such as deductible, coinsurance and more.
It's important to note that Medicare Supplement plans and Medicare Advantage plans are not the same thing. You cannot have a Medigap plan and a Medicare Advantage plan at the same time.
Medicare covers a number of preventive screenings and tests. Medicare also provides coverage for services like alcohol abuse counseling, nutrition therapy, obesity counseling and more.
Medicare Advantage plans (also called Medicare Part C) provide the same coverage benefits as Medicare Part A and Part B combined into one plan.
Many Medicare Advantage plans also offer additional benefits that Original Medicare doesn’t cover, such as certain preventive care and membership to wellness programs like SilverSneakers.
You can use this helpful Medicare plan finder to find a Medicare Advantage plan that works for you.
Maintaining preventive health care can help you live a longer and healthier life, and it can also help reduce your medical spending by potentially helping you avoid costly procedures.
Make an appointment with your doctor today for your Medicare Annual Wellness Visit, or call a licensed insurance agent to learn about additional preventive care benefits that can be found in a Medicare Advantage plan.
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